Osteoporosis: NEET PG High-Yield Essentials
Metabolic Bone Disease: Classification & Diagnostic Criteria
1. WHO Diagnostic Criteria (T-Score)
| Category | T-Score |
|---|---|
| Normal | ≥ -1.0 |
| Osteopenia | -1.0 to -2.5 |
| Osteoporosis | ≤ -2.5 |
2. High-Yield Exam Facts
- Gold Standard: DEXA scan (Dual-energy X-ray Absorptiometry) is the diagnostic gold standard.
- Primary vs. Secondary: Most common form is primary (postmenopausal/senile). Secondary causes include steroid use, hyperparathyroidism, and chronic kidney disease.
- Clinical Presentation: Often a “silent disease.” First symptom is frequently a fragility fracture (spine, hip, or distal radius).
- Biochemistry: In uncomplicated osteoporosis, serum Calcium, Phosphorus, and ALP are normal. If these are abnormal, consider secondary causes or other metabolic bone diseases.
- FRAX Tool: Used to calculate the 10-year probability of a major osteoporotic fracture.
- Screening: Routine screening for women ≥ 65 years and men ≥ 70 years.
- Management: Bisphosphonates are the first-line antiresorptive agents. Teriparatide (PTH analog) is used for severe disease as an anabolic agent.