A MAN 60 TH WITH

OSTEOPOROSIS
Marcellino Mettafortuna Sephberlian
Emergency Departement Juliana Hospital
Bogor
•An Inpatient topic
Osteoporosis
INTRODUCTIONS:

• Osteoporosis, or porous bone, is a disease characterized by

low bone mass and structural deterioration of bone tissue,
leading to bone fragility and an increased risk of fractures
of the hip, spine, and wrist
Background
• The problem
Osteoporosis is common
Over 50% of women and 30-45% of men over age 50 have
osteopenia/osteoporosis
White woman over age 50: 50 % lifetime risk of osteoporotic fracture, 25%
risk vertebral fracture, 15% risk of hip fracture
Man over age 60 has 25% risk osteoporotic fracture
70% over age 80 have osteoporosis
Who Gets Osteoporosis?
 Age
 Estrogen deficiency
 Testosterone deficiency
 Family history/genetics
 Female sex
 Low calcium/vitamin D intake
 Poor exercise
 Smoking
 Alcohol
 Hyperthyroidism
 Prednisone use
 Low sun exposure
 Medications (antiepileptics, heparin)
 Malignancies (metastatic disease;
multiple myeloma can present as
osteopenia!)
 Low body weight/anorexia
 Hemiplegia s/p CVA/ immobility
 RESULT
• a 60-year-old male patient came to the emergency
room at JULIANA Hospital with back bone pain
.Pain was felt to increase every day, even though
the patient had a history of accidents
approximately three years ago, where the patient
when it rode a motorcycle, when after the incident
the patient did not go to the doctor, only goes to
the masseur, shortly after from the masseur the
patient feels comfortable, then the patient does not
feel strange, does the activity as usual
• one week before, the patient feels pain in the
backbone, increases when doing the activity,
resting feels pain, because it is not strong
complaints of pain the patient is accompanied by
the family come to the IGD JULIANA Hospital.
physical examination

• he was well-known for his distress due to pain at

the level of the lower thoracic / lumbar spine .The
pupils were round, equal, and reactive to light.
Visual fields were normal to confrontation. The
skin turgor was normal, the mucous membranes
were both in good condition with no decay.
Examination of head and neck was normal,The
cardiovascular, respiratory, and abdominal exams
were within normal limits. No edema in the
extremities and neurological assessment was
normal.
Xray Examination
Xray Examination
Xray expertise
Therapy
• Analgesia injection therapy in emergency departemen
• Calcium suplemen
• Bifosfonat tablet
• Analgesia tablet
• Dietetic actions: a high calcium diet (green vegetables, etc.), added with vitamin
D. This therapy is more beneficial as a preventive measure. In the elderly must be
given along with other types of therapy.
• Refer and controling to surgery
• Education
• Management of osteoporosis-only patients without fractures is easier
than patients who date fractures. Read further with osteoporosis
fractures Required at maturity, Required multilevel people, including:
• Assessment of osteoporosis, primary, or secondary, manifestations
elsewhere.
• Assessment of the fracture. Operable or not, if you are operated on, you
should approach the surgeon. After surgery, good rehabilitation measures
accompanied by medication for osteoporosis testing can be done.
DISCUSSION
• In this case the patient is diagnosed with osteoporosis, from the
patient's complaint where the pain is in the spine and there is a
history of trauma, and the pain does not decrease with rest, the more
pain with activity,