3.  Trabecular more metabolically active  Bone loss leads to thinning and perforation of trabecular plates  Osteoporotic fractures occur at sites with at least 50% trabecular bone

4. Highlighted areas have at least 50% trabecular bone

5.  Peak bone density is achieved by late 20s/early 30s  Bone loss after skeletal maturity is about 1% per annum in both sexes  Greater loss in woman for around 3 years following menopause

7.  1 in 3 postmenopausal women  1 in 10 men over 50

8.  Primary  Type 1 (postmenopausal)  Type II(senile)  Idiopathic  Secondary  Endocrine (hyperthyroidism, Cushing’s)  Gastrointestinal (coeliac TPN Crohn’s)  Rheumatologocal (RA ankylosing spondylites)  Malignancy  Drugs (corticosteroids heparin)

11.  DXA stands for :- Dual Energy X-Ray Absorptiometry  DXA measures, it is NOT an imaging machine  Measurements are taken from the axial skeleton

14. Performed if either of other preferred sites are unusable or in the case of certain conditions Endocrine or gastrointestinal

15. Shows body composition Used for research Occasionally used to monitor weight – fat loss, muscle gain

23. WHERE