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  • 733.0 Osteoporosis
  • 733.00 Osteoporosis unspecified
  • 733.01 Senile osteoporosis
  • 733.02 Idiopathic osteoporosis
  • 733.03 Disuse osteoporosis
  • 733.09 Other osteoporosis

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  • M81.0 Age-related osteoporosis without current pathological fracture
  • M81.8 Other osteoporosis without current pathological fracture

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  • 4A: Primary Prevention/Risk Reduction for Skeletal Demineralization
  • 4B: Impaired Posture
  • 4C: Impaired Muscle Performance
  • 4F: Impaired Joint Mobility, Motor Function, Muscle Performance, ROM and Reflex Integrity Association with Spinal Disorders
  • 4G: Impaired Joint Mobility, Muscle Performance, and ROM Associated With Fracture

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Description

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  • Deterioration of bone mass and density with a marked decrease in cortical thickness and cancellous bone trabeculae, leading to increased fragility, deformity and/or fracture
  • Osteoporosis is initially categorized by etiology and skeletal localization then further divided into primary and secondary classifications
  • Considered both a progressive and chronic disease with primary prevention tied to childhood bone health and reduced risk factors (skeletal and nonskeletal)
  • Primary osteoporosis
    • Type 1: postmenopausal osteoporosis
    • Type 2: age-associated (senile) osteoporosis
    • Idiopathic osteoporosis (juvenile, premenopausal women, middle-aged men)
  • Secondary osteoporosis (identifiable cause of bone loss)
    • Underlying disease, deficiency, or drug induced

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Essentials of Diagnosis2-5

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  • The operational definition of osteoporosis by the World Health Organization (WHO) is bone density that falls 2.5 standard deviations (SDs) or more below the mean for a young healthy same sex adult; referred to as a T-score of -2.5
  • Bone mineral density (BMD) measurements are related to both peak bone mass and bone loss
  • Bone densitometry: normal BMD within 1 SD of the mean; T-score at -1.0 and greater
  • Bone densitometry: low BMD (referred to as osteopenia) occurs between 1 and 2.5 SDs below the mean; T-score between -1.0 and -2.5
  • Increased fracture propensity is due to demineralization secondary to osteoporosis; often occurs at the spine, hips, pelvis, or wrist
  • As a comorbid condition, low levels of serum 25-hydroxyvitamin D are noted
  • Accurate patient and family medical histories and early recognition through physical examination may lead to improved therapeutic outcomes
  • 10-year risk for fracture can be measured through Fracture Risk Assessments (FRAX® score)
  • Pharmacotherapy can be measured through changes in laboratory values

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General Considerations2-5

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  • Osteoporosis is considered a major public health problem of the elderly, especially postmenopausal women
  • Lifetime osteoporosis-related fracture will be experienced by 50% of all women and 25% of all men over age 50
  • Persons with low BMD are at an increased risk for the development of osteoporosis; prevention is critical to reduce incidence
  • According to the National Osteoporosis Foundation (NOF), over 10 million Americans have osteoporosis and another 34 million have low BMD, and therefore at increased risks for the development of osteoporosis

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Demographics2-5

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  • Osteoporosis is the cause of approximately 1.5 million fractures per year, with 80% occurring in women and 20% occurring in men
  • Recovery to pre-fracture levels of activity and function are estimated to be only 33% of all sustained fractures
  • More than ...

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