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Bone Remodelling - Coggle Diagram

- - - - 70 years of age, 65-69 with 1 risk factor, 50-64 with previous fracture or >2 risk fractures
      - Previous hip/spine fracutre, >2 fracture events
    - - T score # of SDs from average person at peak bone mass
        
        Diagnostic Critea
        
        Normal: T score >-1
        
        Osteopenia: T score between -1 and -2.5
        
        Osteroporotos T score <-2.5
        
        Severe Osteoporosis: T score <-2.5 with Hx of fragility fractures
      - Z score: # of SDs compared to average person of same gender, age, race
    - - Calcium, albumin, CBC, creatinine, ALP, TSH, SPEP, 25-OH
  - - - Type 1: Loss of trabecular bone
      - Type 2: Predominantly cortical bone loss
    - - Specific clinical disorders that cause low bone mineal ensity
    - - Transient that affects previously healthy 87-14 year olds
  - - - Suggest: 10 yr fracture risk 15-19.99%, T score <2.5 and age <70, and if not started reassess in 5 year if 10 year fracture is 10-15 or in 3 year if >15%
      - Recommend if: Previous hip/spine fracture, >2 fracture events, 10 yre fracture risk >20, T score <2.5 and >70
    - - Common 1st line treatment which inhibits osteocalsts
      - Pros: reduces fracture, increased benefit/safety
      - Cons: Esophagitis, soteonecrosis, atypical subtrochanteric fractures
    - - Pros: Reduces fracture vertebral and non-vertebral fractures
      - Cons: osteonecrosis, atypical subtrochanteric fracture,s rebound bone lsos
    - - Pros: Decrease in Breast cancer
      - Cons: Increase in hot flashes,. thromboembolic disease, and no evidence in reduction in non-vertebral fractures
    - - Pro: Decrease osteoblastic activity, increases bone density, treat symtpoms of estrogen deficiency
      - Cons: Increase CVD and PE risk, increase breast cnacer risk, adverse effect on cognition
- - - - Type 1 diabetes, untreated hyperthyroidism, hypogonadism, chornic malnutrition, malabsotrption, chronic liver disease