Osteoporosis: The causes, symptoms, tests to diagnose it

Osteoporosis is a progressive and generalized reduction of bone tissue, which leads to a weakening of skeletal tissue. Bone fractures represent its main clinical manifestation.

Osteoporosis can be primary or secondary, but the latter is much less frequent and is responsible for less than 5% of cases. There are three types of primary osteoporosis:

• Idiopathic osteoporosis occurs in children and young adults of male and female, with normal gonadal functions.
• Type I osteoporosis or postmenopausal osteoporosis occurs mainly in people aged 51 to 75, with six times higher prevalence in women.
• Type II osteoporosis or senile or invasive osteoporosis occurs in people over 70 years of age and is doubly prevalent in women.

Causes of osteoporosis

The main causes of osteoporosis are the loss of calcium and minerals in the bone. However, such situations occur for other causes, which are different from time to time, depending on the type of osteoporosis.

The causes of idiopathic osteoporosis are not yet known; at the base, there may be hereditary factors, but not yet much is known about the reasons for this form of the pathology, which is rather rare.

Type I osteoporosis is mainly attributed to endocrinological changes that occur in women after menopause, especially the drop in estrogen production. However, it is also found in men in subjects with low serum testosterone levels and/or in those who have undergone castration.

Type II osteoporosis is related to natural aging processes. Following the reduction in the number of osteoblasts and their activity, the balance of bone remineralization remains at a loss. In addition, in older people, there is a reduction in Vitamin D, significant for the intestinal absorption of calcium and phosphorus and their deposition at the level of the bones.

Secondary osteoporosis is mainly due to endocrine causes, to the intake of some drugs (for example, example, prolonged intake of barbiturates, heparin, and corticosteroids) and causes classified as miscellaneous, i.e., various, including alcoholism, cigarette smoking, rheumatoid arthritis, sarcoidosis, chronic kidney failure, COPD.

Symptoms of osteoporosis

Osteoporosis has been called the silent killer; although it is a rather serious disease, it can remain asymptomatic even for many years.

Obviously, when the condition worsens or becomes more complicated, symptoms such as even very sharp and persistent pain, mainly localized to the lumbar spine, follow osteoporosis; in addition, varus type bone deformities may occur.

The areas most affected are subject to fractures (one of the best-known symptoms of osteoporosis), which can be spontaneous or consequent to trauma, even mild. However, fractures in the context of osteoporosis are severe; in people with this pathology, fractures and being very frequent tend to heal with difficulty.

Test to diagnose osteoporosis

Suspicion of osteoporosis may arise as a result of bone fractures or other symptoms. Following a clinical examination, diagnosis is made, evaluating the symptoms manifested by the patient and diagnostic tests.

The reference technique for diagnosing osteoporosis is MOC (computerized bone mineralometry). There are different types of MOC. The most-used technique is MOC DXA, also known as MOC DEXA, an acronym for Dual Energy X-ray Absorptiometry (dual-energy X-ray absorptiometry or bone densitometry with X-ray absorption technique).

The MOC is an exam that does not require particular maneuvers nor a specific preparation; the subject is invited to deprive himself of all metal objects and then made to lie down on a bed and placed under the device that allows the test.

It is not an invasive diagnostic test; it poses some risk as it involves radiation exposure. However, you need to know that these are low dosages, much lower than those you are exposed to when undergoing a chest CT scan. The MOC can be a total body extended to the whole body or localized to the affected areas, such as the femur or vertebral column.