What it is osteopenia and how to treat it: what is the difference from osteoporosis
Osteopenia, as an early precursor to osteoporosis: how to treat and diagnose?
In order to comprehend the mysterious and leisurely life of the bone and an equally unhurried her death, do not have to penetrate the body, down to the size of the ubiquitous red – this pervasive x-rays. At least, in order to see how the bone «melts».
That way, for decreases as the fraction of its mass in the total body weight, and the weight and volume of mineral matter in itself.
In radiology picture of the internal structure of the studied object presented in negative form, called the x-ray shadow. When osteopenia this shadow thins the density of the bone structure as the body decreases.
If the process of «melting» of the bone is called osteoporosis, the bone picture imprinted on the image at the moment and saying, bones – small, this is osteopenia, the picture in the chronicle of osteoporosis.
Why the shadow of the bones with each passing month more transparent
The process of developing osteoporosis can be compared with the life of a tree: the General contour and occupied space remains within the same borders, but the wood becoming more friable, shamelessly pilfered by pests living under the bark the larvae and settled in the tree mushroom fungus.
Who is the «bark beetles» and «tinder» in relation to bones, what causes its slow death?
Among the factors of bone destruction main the following:
- endocrine pathology;
- concomitant pathology;
- created as a result of long-term use of medications.
The first group of causes include as gender and age (often marked osteopenia in women and the elderly and old age), and critical high growth (over 172 cm in women and more than 183 cm in men) or low weight.
They also include individual characteristics of the anatomy (bone structure) and physiology (intolerance to products produced from milk).
To leaching of bone minerals leads to the hormonal imbalance of any nature (in the form of early menopause, or endocrine pathology: hyperparathyroidism, diabetes mellitus), and addiction to alcohol and coffee and accommodation in the regions of the far North, leading to hypovitaminosis D.
Osteopenia can cause, as the use of drugs of various nature effects on the body (cytostatics, glucocorticoids, antibiotics tetracycline), and the need for prolonged parenteral nutrition and condition due to organ transplantation.
A separate group of causes form of the disease:
- of the digestive organs, leading to impaired absorption of minerals;
- of the hemopoietic system and blood circulation (impaired transport function of blood);
- autoimmune diseases and systemic diseases of connective tissue;
- the failure of the liver and kidneys.
The first suspicious signs
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Any significant changes in health does not cause osteopenia until then, until the surprise causing a fracture when falling very trifling, or suddenly diagnosed with a compression fracture, which occurred even without apparent reason and without pain.
Or there comes a time x-ray «findings» in the form of rarefaction of the bone shadows in the picture, made about a completely different, not bone pathology.
Careful, many years familiar with the population of the area, the therapist can always be noted and indicate «his» patient to those small changes in body condition, which he himself does not notice, for he sees himself every day:
- growth reduction (due to lowering of height of the vertebral bodies);
- difficulty standing and sitting (due to the development of hip pathology);
- the absence of its sun (the patient is «abandoned» the house and «sat down»);
- the fingers began to «wax to transparency.»
A thorough analysis of the habits, lifestyle of the patient, «set» his diseases «clips» consumed drugs in their totality allow and without an x-ray to assume that the presence of osteopenia (or osteoporosis).
The typical patient is a woman over 50 for a small increase in overweight (in view of the longstanding use of glucocorticoids about bronchial asthma), with surgically removed ovaries, living alone and usually eating «dry rations» (besides, who can not tolerate dairy products.)
Based on this analysis, it is possible with high probability to «guess» the location of the next possible turning point.
The «breaking» are subjected to the greatest axial or transverse load of the bone, or not protected by a thick layer of soft tissue portions of the skeleton:
- the body of the vertebrae (fractures from falling back and to the side);
- the shoulder and the bones of the forearm (due to a drop on the exposed hands);
- fibula (fracture when fixed, Zipovskaya stop);
- neck thighs (due to anatomy).
This method of radiation diagnosis distinguishes between 3 types of osteopenic manifestations (or pathologically low bone mass):
- Osteoporosis is celebrated as the destruction of the organic matrix structures and entrainment of bone mineral (simultaneously) due to the low activity of osteoblasts. The characteristic feature of the beams are thinned and spongy and compact substance of the bone, the broken communication between crossing each other beams, with perforation and failure of individual beams.
- To osteomalacia characterized by insufficiently high level of mineralization of bone tissue with a predominance of poorly mineralized organic matrix and disruption of the normal ratio of mineral and organic substances, leading to loss of bone stiffness and the appearance of pathological flexibility.
- Osteopenia in the form of fibrous-cystic osteitis is characterized by enhanced resorption of the organic matrix of the structures and mineral substances with substitution of fibrous tissue. This picture is typical for severe hyperparathyroidism (activation of osteoclasts caused by excessive secretion of parathyroid hormones).
In most cases, osteopenia has all these kostnadene changes, but one of the diseases is predominant.
With the most accurate diagnosis allows the use of the DEXA (dual energy x-ray absorptiometry), or densitometry, which allows to identify 2% for the year rarefaction of bone tissue density (which is not possible during standard radiography).
To an equally important methods of research are:
- biochemical (determination of the status of phosphorus-calcium metabolism and activity levels of calcium-regulating hormones);
- a study of iliac bone biopsy (to exclude a diagnosis of multiple myeloma).
Complications and prognosis
Osteopenia, which is not treated, smoothly and imperceptibly into the next stage of bone destruction – osteoporosis, when bone fractures are transferred to the category of real events.
Moreover, the bone thins and becomes so brittle that a fracture can occur without the application of considerable physical effort, from a simple turn of the body in bed during sleep.
The prognosis of the hip fracture due to osteopenia (osteoporosis) is often tantamount to a death sentence: sentenced to many months lying in bed (in the hope the bone’s healing) old people with disabilities of the body often dies from the inevitably emerging in this situation of stagnant pneumonia.
Vertebral fractures (especially multiple and repeated), due to the progression of osteopenia are fraught with various neurological pathologies: lumbago to extremely limited mobility in the spine (as for the pain in him, and by reason of his physical insolvency).
A special kind osteopenia-osteoporosis is steroid (or postmenopausal women) variant, leading to multiple rib fractures.
How to help your bones don’t crumble
To restore the normal structure of bones and fortresses necessary to achieve a balance in phosphorus-calcium metabolism and vitamin D return to his place in this exchange.
One should not ignore the shortage in the body:
- silicon, magnesium, manganese, boron, fluorine, copper, zinc;
- vitamins A, C, E and K.
Therefore, the first task is to return to the metabolism of all these missing components through diet and the body’s need for each of them is determined by laboratory analysis.
Getting rid of bad habits including drinking and Smoking, abuse of coffee and salinities, reduces the loss of calcium.
Among the recommended foods should give preference to yogurt products containing soluble forms of calcium products, causing the acidosis, it is necessary to recommend to use in smaller quantities.
The main event in the treatment of osteopenia is to eliminate its causes – diseases that lead to it (in case of violation of the absorption of nutrients from food is the recovery of organs of digestion).
If necessary, is replacement therapy with hormones (progesterone and estrogens), drugs used class of bisphosphonates this is especially important with the threat of escalating osteopenia to osteoporosis.
A little bit about prevention
Measures to prevent «melting» of the bone, are strengthening their strengths using:
- balanced diet;
- moderate sun exposure, leading to the appearance of sunburn;
- dosed physical load on the body (sports, dancing, fitness, Hiking);
- refusal of habitual intoxication and abuse of individual types of products;
- regular medical examinations.
Only ceasing to destroy its own bone and other tissues of the body unknowingly to them, it is possible to stop the progression of the disease and to achieve the opposite of its development.