1. By hamidreza soltanian 8533047

2.  Osteoporosis is a Greek word meaning porous bone.  While osteoporosis is mostly seen in women (80 %), it can occur at any age and gender depending on some risk factors.  About 50 % of women having osteoporotic fracture require long term care.

4.  Bone tissue is under the exposure of excessive stress during daily activities.  Excessive osteoclast or insufficient osteoblast number causes improper filling of resorption site and this leads to low bone mass.  Women in their postmenopausal stage are in the highest risk group of osteoporosis.  ERT,HRT

5. MODIFIABLE FACTORS  Smoking  Excessive alcohol consumption  anticonvulsants usage  Low Ca,Vitamin D diet  Estrogen lacking  Low body weight (<43 kg)  Sedentary lifestyle UNMODIFIABLE FACTORS  Personal fracture history  Fracture history in family  Elder age  History of organ transplants  Connective tissue disorders  Hormonal disorders

6.  Back pain  Height loss  Neck strain  Fractures  Body deformation

7.  Dual energy X-ray absorptiometry (DEXA) and quantitative computed micro tomography (QCT) measurements are done from central site.  BMD testing compares the patient’s BMD measurement with young man’s BMD value.

8.  The standard deviation (SD) of the patient’s BMD result from the mean is computed. SITUATIONT SCORESTANDARD DEVIATION (SD) NormalT > -1Less than 1 Osteopenia (low bone mass) -2.5 < T < -1Between 1 and 2.5 OsteoporosisT < -2.5More than 2.5 Serious osteoporosis{T< -2.5 } + {having 1 or more fractures} More than 2.5 + having one or more fractures

9. Screening Methods ADVANTAGESDISADVANTAGES Low amount of radiation exposure, fast, effective in serial applications, inexpensive, regularly updated with new software Osteoarthritis may cause an overestimated result, should be corrected by an expertised operator Most sensitive, can make 3D analysis, many application sites Large amount of radiation exposure, ineffective in serial applications, expensive No radiation exposure, cheapest, fast, portable, usable in office environment Limited application sites, limited accuracy  Dual energy X -ray absorptiometry (DEXA)  Quantitative computerized tomography (QCT)  Heel ultrasound (HUS)

10. Screening Methods ADVANTAGESDISADVANTAGES Cheap, effective in serial screening applications Oldest technique, limited application areas, radiation exposure, can give a general idea if there is a huge amount of bone loss like 40- 50% No radiation exposure, fast, can directly supply ideas about the risk factors Does not give a quantity value to make comparison, not accurate and may lead to wrong diagnosis if the physician is not expertised. Reveals the metabolic sources of osteoporosis if there is any High degree of biologic variability  X- ray  Physical examination  Chemical evaluation of serum and bone markers

11.  Is a means of measuring bone mineral density (BMD).  Two X-ray beams with differing energy levels are aimed at the patient's bones.  Dual energy X-ray absorptiometry (DXA) is the most widely used and most thoroughly studied bone density measurement technology.  DXA scans can also be used to measure total body fat content.

12.  Special considerations are involved in the use of DXA to assess bone mass in children.  Z-score  Also, there are other variables in addition to age which are suggested to confound the interpretation of BMD as measured by DXA.  How to correct it?!(BMAD)  DXA is, by far, the most widely used technique for bone measurements.