Osteoporosis - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes bone loss and osteoporosis, the etiology, signs and symptoms, diagnosis, and treatment options.

Osteoporosis is a decrease in bone strength. The strength of the bone depends on mineral density and bone quality. Osteoporotic bone is at risk of fracture at the hip, wrist and spine. If fracture of the vertebral spine occurs, the patient will have a five fold increased risk for having a second vertebral fracture or hip fracture. A second vertebral fracture means you may have more compression fractures in the future. With one hip fracture, there will be a ten fold increase of another hip fracture occurring. Men with hip fractures have a higher mortality rate than women. Lifetime risk of fractures of the hip, spine and wrist is 40 %.
The decrease of bone strength and bone mass clearly predicts fracture risk. When osteoporosis occurs, cancellous bone or trabecular bone loss occurs.
Difference between osteoporosis and osteomalacia. Osteoporosis is the loss of bone mass. Osteomalacia is the reduced mineralization of the bone.
Osteoporosis affects 45% of women aged 50 or older. There is some correlation between osteoporotic fracture and risk of death. This is logical since 25% of patients with hip fracture die within one year. The lifetime risk is high with senile (type III) osteoporosis. There are about million osteoporosis related fractures that occur per year.
Men and women both begin to start “spending” or losing bone at a certain point in their lives. Banking or building up of bone during youth has benefits during the later years. Osteoclasts and osteoblasts achieve balance and remodeling of the bone. Osteoclasts are irregular shaped giant cells that break down or reabsorbs the bone. The life span of osteoclasts is probably 24-48 hours (may be weeks). Osteoblasts are cells that are responsible for new bone formation. It takes 100-150 osteoblasts to replace bone that is removed by one osteoclast. It takes 3 months and 100-150 osteoblasts to replace bone removed by one osteoclast in 24-48 hours. Osteoporosis has bone mineralization but abnormal osteoclast formation. There is a quantitative but not a qualitative problem of the bone.
Most individuals obtain their peak bone mass between ages of 16 and 25 years. Osteoporosis affects about 45% of women 50 years or older. Osteoporosis has bone mineralization but abnormal osteoclast function.
There are two types of osteoporosis:
1.Type I: postmenopausal which occurs 15-20 years after menopause. It has increased risk of vertebral and wrist fractures. It affects the trabecular bone. It is due to estrogen deficiency. Increased risk of vertebral, wrist fractures.
2.Type II: senile which occurs in men and women over the age of 70 years. It affects cortical and trabecular bone. Vertebral and hip fractures are a risk. It occurs more in females than males with a ratio 2:1. It is due to aging and long term calcium deficiency. With aging the inner bone diameter increases while the cortical thickness of the bone decreases. 20-25% of elderly patients could die within one year suffering of a hip fracture.
Risk factors for osteoporosis include:
•Thin
•North European descent
•people who live sedentary lifestyles
•smoker and drinkers
•anti seizure medications as phenytoin ( Dilantin) and phenobarbital.
Treatment of osteoporosis include:
1-antiresorption:
2-Bone stimulation:
What decides if you develop osteoporosis or not?
•Your savings: you can control this by adding more bone when you are young before the age of 25 years.
•Genetics:
•Social/environmental influences: drugs,drinking,cigarettes (negative), exercise, diet, vitamins (positive)
•Menopause: accelerated bone loss.
•Aging
Female athlete triad:
1-menstrual dysfunction/amenorrhea
2-eating disorders
3-decreased bone mineral density.
It is a syndrome in which eating disorder, amenorrhea, and decreased bone density (osteoporosis) affect certain groups of athletes. For a long distance runner with stress fractures, obtain a menstrual history and get a DEXA scan. Amenorrhea leads to osteoporosis and predisposes the athlete to fracture.
Osteoporosis in spinal cord injury patients
•The peak bone loss occurs 16 months after injury
•2/3 of the bone mass remains
•The knee is usually affected (supracondylar fracture of the femur can occur)

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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step

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