What is Osteoporosis?

Microstructural Basis of Osteoporosis

Normal cortical and trabecular bone displays a dynamic lattice architecture. In osteoporosis, bone resorption outpaces osteoblastic matrix formation, enlarging porous inter-trabecular spaces and thinning bone cortices. The mechanical consequence is heightened bone fragility and elevated susceptibility to low-energy fractures.

The 'Silent Epidemic' Concept

Progressive demineralization causes no visceral pain until a structural fracture occurs. Subtle indicators include progressive dorsal kyphosis ('dowager's hump'), height loss greater than 3 cm, and sudden acute back spasms representing silent vertebral compression fractures.

Primary Fragility Fracture Sites

• Thoracic and lumbar vertebral bodies (compression wedge fractures)
• Femoral neck and intertrochanteric hip fractures
• Distal radius (Colles' wrist fracture following minor slip-and-fall events)

Frequently Asked Questions

What is the definitive clinical test for bone density?

Dual-energy X-ray absorptiometry (DEXA) scans quantify bone mineral density. A T-score of -2.5 standard deviations or lower confirms osteoporosis.

Can pharmacological therapy restore bone strength?

Anti-resorptive agents (bisphosphonates, RANKL inhibitors) and osteoanabolic therapies significantly lower fracture incidence when combined with adequate calcium and vitamin D.