Osteoporosis

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

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

• 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

Description

• 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

Essentials of Diagnosis2-5

• 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

General Considerations2-5

• 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

Demographics2-5

• 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 ...