+++
CONDITION/DISORDER SYNONYM
++
++
733.0 Osteoporosis
733.00 Osteoporosis unspecified
733.01 Senile osteoporosis
733.02 Idiopathic osteoporosis
733.03 Disuse osteoporosis
733.09 Other osteoporosis
++
+++
PREFERRED PRACTICE PATTERNS
++
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
++
PATIENT PRESENTATION
The patient is a 72-year-old woman who is having mid-thoracic pain after a coughing bout. The patient is having a dull ache pain that is constant. Upon X-rays, thoracic compression fractures are found. The patient received kyphoplasty surgery. Physical therapy treatment followed by progressive weight-bearing exercises.
++
Deterioration of bone mass and density with a marked decrease in cortical thickness and cancellous bone trabeculae, which leads 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)
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 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.
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 50.1–4
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 ...