Diagnosis and Treatment of

Osteoporosis
Juan David Gómez Moreu.
Estudiante VII semestre. Medicina.
Universidad Del Norte.
Definition
Osteoporosis is characterized by low bone mass and
structural deterioration of bone tissue, leading to an
increased risk of fractures.

The World Health Organization (WHO) defines

osteoporosis as a spinal or hip bone mineral density
(BMD) of 2.5 standard deviations or more below the
mean for healthy, young women (T-score of −2.5 or
below) as measured by dual energy x-ray absorptiometry
(DEXA).6 Osteopenia is defined as a spinal or hip BMD
between 1 and 2.5 standard deviations below the mean.3,6
Primary osteoporosis is the result of bone loss related
to the decline in gonadal function associated with
aging.

Secondary osteoporosis may result from chronic

diseases, exposures, or nutritional deficiencies that
adversely impact bone metabolism.
MARY GAYLE SWEET, MD, JON M. SWEET, MD, MICHAEL P. JEREMIAH, SIM S. GALAZKA, MD;
Diagnosis and Treatment of Osteoporosis; American Family Physician; Volume 79, 2009; 3
Screening
Diagnosis
Osteoporosis is diagnosed clinically or
radiographically. Osteoporosis may present with low-
impact fractures (occurring from a fall at or below
standing height) or fragility fractures (occurring
spontaneously).

 Osteoporosis is most commonly diagnosed with a T-

score of −2.5 or below as determined by central
DEXA scan of the total hip, femoral neck, or lumbar
spine.
Indications for Treatment
Recommendations about which persons with osteoporosis
should receive treatment vary.

The NOF recommends treatment of postmenopausal women

and men with a personal history of hip or vertebral fracture,
T-score of –2.5 or below, or low bone mass (T-score between
–1 and –2.5) and a 10-year probability of hip fracture of at
least 3 percent or any major fracture of at least 20 percent.2

The 10-year probability of fracture is calculated using the

WHO fracture risk assessment tool
 Frax
Herramienta utilizada para evaluar el riesgo de
fractura en pacientes .
Calculan la probabilidad de fractura a 10 años,
proporcionando la probabilidad de fractura de cadera,
y de las fracturas osteoporóticas mas importantes a
10 años (fractura clínica vertebral, antebrazo, cadera
u hombro)

Assessment of fracture risk and its application to screening for postmenopausal

osteoporosis.
Report of a WHO Study Group. Geneva, World Health Organization, 1994 (WHO
Tomado de : http://www.shef.ac.uk/FRAX/tool.jsp?locationValue=10
 T - Z Score
Z-score: Es la comparación de la densidad mineral ósea de una persona
con los valores considerados normales para su edad y sexo.

T-score: Es la comparación de la densidad mineral ósea de una persona

con la máxima densidad ósea teóricamente alcanzada por la población sana
del entorno, a los 30 años, momento en que como se ha expuesto
anteriormente, se alcanza el máximo capital óseo.

La medición nos informa acerca de si una persona tiene menos de lo

normal o más y de la Desviación Standard (DE) que esto supone

La desviación estándar es un cálculo estadístico que permite cuantificar en

qué medida un resultado se aparta de la normalidad y va a servir para
decidir cuando es preciso un tratamiento .
Tomado de: http://www.cun.es/la-clinica/tratamientos-especializados/osteoporosis/;
Clinica Hospital de Navarra
Treatment Recomendations
MARY GAYLE SWEET, MD, JON M. SWEET, MD, MICHAEL P. JEREMIAH, MD, SIM S.
GALAZKA, MD; Diagnosis and Treatment of Osteoporosis; American Family Physician, Febrero
MARY GAYLE SWEET, MD, JON M. SWEET, MD, MICHAEL P. JEREMIAH, MD, SIM S.
GALAZKA, MD; Diagnosis and Treatment of Osteoporosis; American Family Physician, Febrero
References
MARY GAYLE SWEET, MD, JON M. SWEET, MD,
MICHAEL P. JEREMIAH, MD, SIM S. GALAZKA,
MD; Diagnosis and Treatment of Osteoporosis;
American Family Physician; Febrero 1, 2009.