Causes of Osteoporosis

Written by Lv Yao
Orthopedics
Updated on September 06, 2024
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Osteoporosis is caused by two types of reasons, one is primary disease, and the other is secondary disease. Primary disease is commonly seen in postmenopausal women, as well as in some chronic strain injuries, and the occurrence of some metabolic diseases, which accounts for primary osteoporosis. Secondary osteoporosis may be due to trauma, long-term plaster immobilization, or lack of weight bearing after surgical fixation, leading to disuse osteoporosis.

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What department should I go to for osteoporosis?

Osteoporosis is a metabolic bone disease characterized by reduced bone mass and destruction of bone microstructure, leading to increased bone fragility and susceptibility to fractures. It can be divided into primary and secondary types based on the cause. Secondary osteoporosis has a clear primary cause, often due to endocrine metabolic diseases such as gonadal insufficiency, hyperthyroidism, hyperparathyroidism, Cushing's syndrome, type 1 diabetes, or systemic diseases. Primary osteoporosis is commonly seen in postmenopausal osteoporosis and senile osteoporosis. Therefore, it is recommended to consult an endocrinology or orthopedics department for osteoporosis.

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How to check for osteoporosis?

How is osteoporosis diagnosed? There are several methods currently used for the diagnosis of osteoporosis. One method is X-ray examination, which usually only detects severe cases of osteoporosis and also depends on the amount of radiation used, making it seldom used in clinical settings. Another method is ultrasound testing, referred to as ultrasound bone density testing. It typically examines areas like the heel or the wrist. However, ultrasound bone density can have significant inaccuracies, so it is used more as a screening tool rather than for precise diagnosis. The third method is a bone density scanner. This is currently the simplest and most effective method to diagnose osteoporosis. It involves measuring the Relative Vertebral Density (RVD), where a normal value of 1 indicates that the vertebral body density is higher than that of the intervertebral disc. An RVD value of 0 indicates that the vertebral body density is the same as the intervertebral disc density, which signifies osteoporosis. If the RVD is less than 0, it shows that the vertebral body density is less than that of the intervertebral disc, pointing to severe osteoporosis. The bone density scanning method is very straightforward. The patient simply places a foot or arm inside the machine, and the computer quickly provides the bone density measurement, which is more accurate and cost-effective compared to other diagnostic methods.

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Written by Xie Yi Song
Orthopedics
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Is osteoporosis easy to treat?

Osteoporosis is characterized by low bone mass and destruction of bone tissue microstructure, resulting in increased bone fragility, decreased bone strength, and susceptibility to fractures. It is a systemic metabolic disease. Its treatment includes the following aspects: supplementation with calcium and Vitamin D, and the use of medications that inhibit the activity of osteoclasts. Firstly, calcium supplementation is essential, along with Vitamin D, which promotes the absorption of calcium. Based on the severity of osteoporosis, stronger medications might be necessary, such as bisphosphonates or calcitonin. The choice of treatment plan depends on the severity of the patient's condition. Both bisphosphonates and calcitonin are used to inhibit the activity of osteoclasts. The specific duration of treatment for osteoporosis depends on the patient's condition; additionally, patients need to regularly check their bone density. If the bone density is up to standard, they may stop the medication as per the doctor’s advice and undergo regular check-ups. If a relapse occurs, prompt medical treatment is necessary. Thus, the duration of treatment for osteoporosis is relatively long, generally from six months to a year, or even longer.

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Written by Na Hong Wei
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Osteoporosis detection methods

Osteoporosis is a systemic special disease characterized by low bone mass and damaged bone microarchitecture, which leads to increased bone fragility and susceptibility to fractures. This is the standard set by the World Health Organization in 2017. However, currently in clinical practice, there is no direct method available to measure bone hardness. Therefore, an indirect method is used, which is the measurement of bone density. There are many methods to measure bone density, among which the gold standard is Dual-Energy X-ray Absorptiometry (DXA). Other methods include single photon, single energy X-ray, Quantitative Computed Tomography (QCT), peripheral quantitative CT, and quantitative ultrasound testing.

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What to do with osteoporosis?

When osteoporosis occurs, it is first important to determine the cause of the osteoporosis, whether it's due to postmenopausal women, overuse injuries, or osteoporosis caused by long periods of immobilization following trauma. If such osteoporosis occurs, it is advisable to appropriately supplement with calcium and vitamin D, especially for postmenopausal women and elderly individuals affected by degenerative changes. These supplements can be taken orally, and appropriate physical exercise can be incorporated to increase bone strength and achieve recovery. In cases of disuse osteoporosis, appropriate functional exercises should be performed to allow for active muscle contractions and slight weight-bearing by the bones, which promotes circulation around the bones and reduces the risk of osteoporosis.