Osteoporosis is a multifactorial disease characterized by a progressive decrease in bone mineral density and, as a result, reduced bone strength. This pathology affects all bones of the skeleton, significantly increasing the risk of fractures during everyday activities and minimal trauma. The most common fracture sites include the femoral neck, the distal radius (typical location), and vertebral bodies.
The primary risk group includes women during the menopausal period due to estrogen deficiency caused by reduced production of sex hormones. In addition, osteoporosis may develop as a result of insufficient dietary intake of calcium and vitamin D, fluoride, phosphorus, and proteins, as well as excessive alcohol and caffeine consumption, use of certain medications (calcium antagonists, glucocorticoids), smoking, and low physical activity.
Types of Osteoporosis
Since osteoporosis develops under the influence of multiple factors, its types are classified according to the underlying cause.
Primary osteoporosis includes:
- juvenile;
- involutional (including postmenopausal);
- hereditary;
- idiopathic.
Secondary osteoporosis develops in association with:
- diffuse connective tissue diseases;
- endocrine disorders (hyperparathyroidism, diabetes mellitus, hyperthyroidism, hypogonadism);
- gastrointestinal diseases;
- post-radiation conditions;
- insufficient dietary calcium intake;
- prolonged immobilization;
- hematological disorders (leukemias, multiple myeloma);
- use of medications that reduce calcium levels in the body.
Localized osteoporosis occurs:
- in inflammatory bone diseases;
- after traumatic injuries.
Clinically, osteoporosis is manifested by a classic triad: pain syndrome, bone fractures, and postural changes with skeletal deformities.
Diagnostics
The following diagnostic methods are used to evaluate osteoporosis.
X-ray examination is effective when bone mass loss exceeds 30%. At early stages, it allows only a presumptive diagnosis, as radiographs show a characteristic decrease in bone density.
Densitometry is used for quantitative assessment of bone mineral density. The following types are distinguished:
- X-ray densitometry (DEXA – dual-energy X-ray absorptiometry);
- ultrasound densitometry;
- computed tomography densitometry.
Laboratory diagnostics include:
- thyroid-stimulating hormone (TSH) and free thyroxine (free T4) levels;
- serum ionized calcium, 25-hydroxyvitamin D, and parathyroid hormone levels;
- sex hormone levels (for women – estradiol, testosterone, prolactin, etc.; for men – free testosterone levels).
Treatment of Osteoporosis
Treatment of patients with osteoporosis should be carried out in specialized medical centers. Since this disease is multifactorial, therapy must focus on eliminating the underlying cause and should involve consultations with physicians of various specialties (rheumatologist, cardiologist, neurologist). However, the leading role today belongs to the endocrinologist.
Stages of osteoporosis treatment:
- treatment of the underlying condition causing osteoporosis (hypogonadism, thyrotoxicosis, hypothyroidism);
- therapy aimed at increasing bone mass (bisphosphonates, calcium and vitamin D preparations);
- medications to reduce the intensity of pain syndrome.
Why undergo osteoporosis treatment in Belarus?
Treatment is provided in specialized clinics in Belarus using modern diagnostic and therapeutic methods. A comprehensive approach includes pharmacological therapy, nutritional correction, physiotherapy, and rehabilitation programs aimed at strengthening bone tissue.
