osteoporosis: etiology,diagnosis and management-
TRANSCRIPT
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Jfegngtgmn
K JGSFKSF CHK_KCZF_GRFJ OW2
AMP OMNF DKSS
DGC_M-K_CHGZFCZV_KA JFZF_GM_KZGMN
ME ZHF OMNF ZGSSVF
AFKJGN@ ZM2
FNHKNCFJ OMNF E_K@GAGZW
GNC_FKSF GN E_KCZV_F _GSI
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Nmrdka Omnf vs Mstfmpmrmtgc Omnf
Amss me trkofcuakr paktfs ( rg`ht) rfsuats gn wfkifnfjomnf structurf sg`ngegckntay gncrfksgn` rgsi me erkcturfs.
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Fpgjfdgmam`y
Jgsmrjfr me pmstdfnmpkuska wmdfn me nmrthfrn Furmpfkn
jfscfnt
Gncrfksf gn thf gncgjfncf rfaktfj tm jfcrfksgn` physgckakctgvgty
Mvfr ?0 dgaagmn mr ;me 3 wmdfn krf keefctfj wgth mstfmpmrmsgs
Mvfr 6 dgaagmn mr ;me 6 dfn krf keefctfj wgth mstfmpmrmsgs.
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Erkcturfs
;.6 dgaagmn ex/yr
3
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Ufrtfork Erkcturfs
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Hgp Erkcturfs
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Gdpkct
Chrmngc pkgn Hfg`ht amss Iyphmsgs
Jfcrfksfj sfae-fstffd _fstrgctgvf aun`
jx Cmnstgpktgmn,
kojmdgnka pkgn Jfprfssgmn
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_gsi Ekctmrs
KCZGUF _GSI EKCZM_S
(Dky of mn`mgn` knj afkj tm cuduaktgvf omnf amss)
J_V@S
DKAKOSM_\ZGMN - Kny ckusf2Dfjgcka mr Sur`gcka
MN@MGN@ KACMHMA KOVSF HW\M@MNKJGSD
CH_MNGC GDDMOGAGZW
CH_MNGC JGSFKSF
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_gsi Ekctmrs
GNKCZGUF _GSI EKCZM_SHgstmrgcka knj nmt agifay tm afkj tmeurthfr omnf amss,
mncf fxcaujfj ckn of g`nmrfjthfrfketfr)EKDGAW HGSZM_W
FK_AW DFNM\KVSF \_FUGMVS KDFNM__HMFK \_FUGMVS ZHW_MGJ JGSFKSF \_FUGMVS KACMHMA KOVSF HW\M@MNKJGSD GDDMOGAGZW JV_GN@ OMNF JFUFAM\DFNZ
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Cakssgegcktgmn
\rgdkry
\mstdfnmpkuska mstfmpmrmsgs (typf G)
Ckusfj oy akci me fstrm`fn
Ckusfs \ZH tm mvfr stgduaktf mstfmcaksts Fxcfssgvf amss me trkofcuakr omnf
K`f-kssmcgktfj mstfmpmrmsgs (typf GG)
Omnf amss juf tm gncrfksfj omnf turnmvfr
Dkakosmrptgmn Dgnfrka knj vgtkdgn jfegcgfncy
Sfcmnjkry
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Sfcmnjkry MstfmpmrmsgsJgsfksf stktfs
Kcrmdf`kay Kjjgsmns jgsfksf Kdyamgjmsgs
Knmrfxgk CM\J Hfdmchrmdktmsgs Hypfrpkrkthyrmgjgsd Aydphmdk knj afuifdgk
Dkakosmrptgmn stktfs
Duatgpaf dyfamdk
Duatgpaf scafrmsgs
_hfudktmgj krthrgtgs
Skrcmgjmsgs
Sfvfrf agvfr jz, fsp. \OC
Zhkafssfdgk
Zhyrmtmxgcmsgs
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Sfcmnjkry MstfmpmrmsgsJru`s
Kaudgnud
Kntgcmnvuasknts
Fxcfssgvf ftmh
Fxcfssgvf thyrmxgnfJfpm \rmvfrk
(jfcrfksfj omnf
dkss rfvfrsgoaf ketfr
stmppgn` dfjgcktgmn)
@aucmcmrtgcmgjs
@n_H k`mngsts
Hfpkrgn
Agthgud
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Pmraj Hfkath Mr`kngzktgmn (PHM) JfegngtgmnOksfj mn ODJ tfstgn`
Nmrdka2 Z scmrf komvf ;
Mstfmpfngk2 Z scmrf oftwffn ; knj ?.6
Mstfmpmrmsgs2 Z scmrf kt mr ofamw ?.6
Sfvfrf mstfmpmrmsgs2 Z scmrf ?.6 mr
amwfr gn thf prfsfncf me ; mr dmrferkcturfs
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Z scmrfs vs. R scmrfs
Z scmrf nudofr me SJs k pktgfnts ODJjfvgktfs ermd k rfefrfncf pmpuaktgmn menmrdka ymun` kjuats
R scmrf nudofr me SJs k pktgfnts ODJjfvgktfs ermd k rfefrfncf pmpuaktgmn mesuobfcts me thf skdf k`f knj sfx
R scmrfs gnjgcktf whfthfr thf ODJ rfsuat gs
fxpfctfj emr thf pktgfnts k`f. Ge gt gs duchafss thkn fxpfctfj, suspfct k sfcmnjkryckusf me mstfmpmrmsgs (usf ? ks k cutmee)
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Zypfs me ODJ tfstgn`
Juka fnfr`y x-rky kosmrptgmdftry (JXK mr JFXK). @maj Stknjkrj Dfksurfs ODJ gn spgnf, hgp, mr wrgst Cmdpaftfj gn k efw dgnutfs _kjgktgmn fxpmsurf gs afss
Vatrksmunj jfnsgtmdftry Dfksurfs ODJ gn hffa, pktfaak Cmst-feefctgvf \mmr cmrrfaktgmn oftwffn VS knj JXK Gncmnsgstfnt ymun` nmrdka rfefrfncf
pmpuaktgmns dky cmntrgoutf Sgn`af-fnfr`y x-rky kosmrptgmdftry knj pfrgphfrka
juka x-rky [ukntgtktgvf cmdputfj tmdm`rkphy ([CZ) _kjgm`rkphgc kosmrptgmdftry
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DFKSV_FDFNZ ME OMNF
DGNF_KA JFNSGZW
\AKGN X-_KW
SGN@AF \HMZMN KOSM_\ZGMDFZ_W
JVKA \HMZMN KOSM_\ZGMDFZ_W
JVKA X-_KW KOSM_\ZGMDFZ_W
[VKNZGZKZGUF CMD\VZFJZMDM@_K\HW
VAZ_KSMVNJ
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\rmoafds wgth gntfrprftktgmn me ODJ
tfstgn`
@ugjfagnfs jfvfampfj emr Ckucksgkn wmdfnout hkvf offn kppagfj tm kaa rkcfs
Mvfrfstgdktgmn me ODJ
Erkcturf sgtf\rf-fxgstgn` jfvfampdfntka omnf konmrdkagtymstfmphytfs (cmddmn gn spgnf, sm hgp dky of dmrf
kccurktf gn pfmpaf >56)
Vnjfrfstgdktgmn me ODJ
Strmif mr trkudk afkjgn` tm agdo gnkctgvgtyNffj tm fstkoagsh stknjkrj emr cmdpkrkogagty
me jgeefrfnt jfvgcfs knj knktmdgc sgtfs
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Phfn tm Dfksurf ODJ gn
\mstdfnmpkuska Pmdfn
Kaa wmdfn 56 yfkrs knj majfr
\mstdfnmpkuska wmdfn 156 yfkrs mek`f2
Ge rfsuat dg`ht gneaufncf jfcgsgmns komut
gntfrvfntgmn
Mnf mr dmrf rgsi ekctmrs
Hgstmry me erkcturf
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Phfn Dfksurfdfnt me ODJ Gs
Nmt Kpprmprgktf
Hfkathy prfdfnmpkuska wmdfn
Hfkathy chgajrfn knj kjmafscfnts
Pmdfn gngtgktgn` FZ/HZ emrdfnmpkuska sydptmd rfagfe(mthfr mstfmpmrmsgs thfrkpgfs
shmuaj nmt of gngtgktfj wgthmut
ODJ dfksurfdfnt)
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Juka Fnfr`y X-rky Kosmrptgmdftry_fsuats
Omnf dgnfrka jfnsgty ODJ
Fxprfssfj gn `rkddfs pfr cd? (`/cd?)
Nffj tm cmdpkrf wgth fstkoagshfj rfefrfncf rkn`femr thf
kpprmprgktf pmpuaktgmn. Egnka rfsuat fxprfssfj ks k stknjkrj jfvgktgmn ermd
thf dfkn
ODJ me kn k`f knj sfx dktchfj rfefrfncf sft
(z-scmrf)
Knj K stknjkrj jfvgktgmn ermd thf dfkn ODJ me sfx
dktchfj ymun` kjuat
(t-scmrf)
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Phfn tm gngtgktf trfktdfnt
Hg`h _gsi
Z scmrf 1-?.< ---------------- Zrfkt Dmjfrktf _gsi
Z scmrf ;.6 tm ?.< --------
Zrfkt ge mthfr rgsi ekctmrs krf prfsfnt
Amw _gsi
Z scmrf komvf ;.6 ---------
Chfci k`kgn gn ;-? yfkrs
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Phfn tm _ftfst
_fpfkt tfstgn` gn ? yrskjjgtgmnka omnf amssrfspmnsf tm trfktdfnt
Dmrf erfqufnt tfstgn` ge2`aucmcmrtgcmgj thfrkpy emr
dmrf thkn 3 yfkrs
fvgjfncf me k sfcmnjkry ckusfme mstfmpmrmsgs
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Omnf Dkrifrs
Sfrud mstfmckacgn,
prmcmaak`fn G
ckromxytfrdgnka prmpfptgjf,prmcmaak`fn typf G N-
tfrdgnka prmpfptgjf,
N knj C-tfampfptgjfs
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Zrfktdfnt\rfvfntgvf Dfksurfs
\rfvfntgmn me Omnf Amss
Ckacgud
H_Z
SF_DS
Ckacgtmngn Ogsphmsphmnktfs
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Ckacgud _fqugrfdfnts
NM EG_DCMNCAVSGMNS
V.I.
DKAFS ;; - ;8
WFK_S
;
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Smurcfs me Ckacgud
EMMJ SF_UGN@ SGRF CKACGVD(d`)
DGAI - PHMAF ; @AKSS (;7
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Gnjgcktgmns emr trfktdfnt me
mstfmpmrmsgs
\h a g a t t t
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\hkrdkcmam`gcka trfktdfnts2
dmjfs me kctgmn
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Zrfktdfnt
Fstrm`fn _fpakcfdfnt Zhfrkpy (F_Z)
Gnjgcktgmn2 Vsfj tm prfvfnt knj trfktmstfmpmrmsgs (EJK gnjgcktgmn gs emrprfvfntgmn)
Dfchkngsd2Jfcrfksfs mstfmcakstkctgvgty
Jmsf2 Fstrm`fn2
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F_Z Kjvkntk`fs Gncrfksfs omnf jfnsgty (;-
6%) knj jfcrfksfs rgsi meerkcturf (?6%)
_fagfe me hmt eakshfs,vk`gnka jrynfss
Jfcrfksfs AJA, gncrfksfsHJA
\rfvfntgmn me Kazhfgdfrsjgsfksf
_faktgvfay gnfxpfnsgvf
Jgskjvkntk`fs Kccfafrktfj omnf amss ketfr
stmppgn`
Gncrfksfj rgsi me utfrgnf ck(ge unmppmsfj)
Gncrfksfj rgsi methrmdomfdomagc fvfnts
\mssgoaf gncrfksfj rgsi meorfkst ckncfr
Sgjf feefcts2 orfksttfnjfrnfss, orfkithrmu`h
oaffjgn` Gncrfksfj rgsi me cmrmnkry
fvfnts gn wmdfn wgthinmwn CKJ gn egrst yfkr meusf (HF_S trgka)
S a tg F t _ t
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Sfafctgvf Fstrm`fn _fcfptmr
Dmjuaktmrs (SF_Ds)
Gnjgcktgmn2 Zrfktdfnt knj
prfvfntgmn me mstfmpmrmsgs
Dfchkngsd2 Jfcrfksfs
omnf rfsmrptgmn
Jmsf2 _kamxgefnf (Fvgstk)5
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SF_DS Kjvkntk`fs
Gncrfksfs omnf jfnsgty
(?%) knj jfcrfksfs
erkcturf rgsi (3
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Ogsphmsphmnktfs Kpprmvfj k`fntsKafnjrmnktf (Emskdkx), _gsfjrmnktf
(Kctmnfa)
Gnjgcktgmn
Kpprmvfj emr prfvfntgmn knj trfktdfnt me mstfmpmrmsgsgncaujgn` stfrmgj-gnjucfj mstfmpmrmsgs
Dfchkngsd Ognj tm hyjrmxkppftgtf kt sgtfs me kctgvf omnfrfsmrptgmn gnhgogtgn` mstfmcakst eunctgmn
Jmsf
\rfvfntgmn
Kafnjrmnktf 6d` qj mr 36d` qwffi _gsfjrmnktf 6d` qj mr 3
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Ogsphmsphmnktfs
Zkif egrst thgn` gn kd, nm emmj mrdfjs emr 3< dgnutfs
Zkif wgth 8mz `akss me wktfr
Jmnt agf jmwn emr kt afkst 3< dgnutfs
Sfpkrktf Ck, Ka, knj D` cmntkgngn`dfjs oy kt afkst : hmurs
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Ckacgtmngn
Gnjgcktgmn2 Zrfktdfnt mnay
Jfcrfksfs omnf rfsmrptgmn
Jmsf2 Nkska (Dgkckacgn) ?
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\krkthyrmgj Hmrdmnf
Jkgay SC gnbfctgmns me :
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