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Osteoporosis
Osteoporosis is a generalized bone diseases characterized bone diseases characterized by decreased osteoblastic matrix formation combined with increased osteoclatic bone resorption causing a marked decrease in the total amount of bone in the skeleton (osteopenia). Increased bone resorption may be a more important factor than decreased osteoblastic formation. Since generalized osteoporosis represents a disturbance not only in bone deposition but also in bone resorption, osteoporosis classified based on the most prominent factor in their etiology and the onset of the disease, even though the resultant skeletal lesion is the same. The types of osteoporosis include postmenopausal, involutional, idiopathic, juvenile and secondary osteoporosis. The most frequent form in Caucasians and Asians is postmenopausal osteoporosis. Because the survival in the population throughout the world in the increase this type is the more important one, it has been estimated that at least one in three women over 60 will develop an osteoporosisrelated fracture while one in six men oven the age of 75 will develop osteoporosis. Diagnosis of osteoporosis can be made by history of previous fractures, clinical symptoms and signs, laboratory examination and radiologic examination. Bone biopsy is rarely needed to rule out other metabolic bone diseases; it is sometimes used to quantitate bone loss. Management should include encouragement of physical activity throughout life, restriction of tobacco and alcohol consumption, maintenance of adequate calcium intake, and avoidance of estrogen deficiency. In osteoporosis in the elderly, it must be remembered that hip and wrist fracture are usually precipitated by a fall. Steps should be taken to reduce the insidence of falls wherever possible; this may require review of psychotropic, antihypertensive and other medications, assessment of the home and external environment and provision of suitable aids, and evaluation of visual problems. General exercises also have a role in maintaining balance in the elderly.
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