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1、Section5OsteoporosisDefinitionOsteoporosisisasystemicskeletaldiseasecharacterizedbyLowbonemassMicroarchitecturaldeteriorationofbonetissue,LeadingtoincreasedbonefragilityAndgreatersusceptibilitytofracture原发性骨疏松是一种以骨量低下，骨微结构破坏，导致骨脆性增加，易发生骨折为特征的全身性骨病ⅠEpidemiologyIncidence/100,
2、000personyearWomen>=8535-39Epidemiologyofvertebral,hip,Colles'fractureswithageIncidenceoffracture(fracturesper1000patientyears)IIPathophysiologyRemodeling(骨重建过程)Mechanismofboneremodeling.破骨细胞成骨细胞MenopauseAgingOtherriskFactorsHormonalcontrolofboneresorption.ⅢClinicalcharacte
3、riticsOsteoporosisoftenstartssilentlyandmaynotbefounduntilabonefractures.Fragilityfractureisatypeofpathologicfracturethatoccursasresultofnormalactivities,suchasafallfromstandingheightorless(theNationalOsteoporosisFoundation,NOF)1.5millionfracturesoccureachyearinUSasaconsequ
4、enceofosteoporosis700,000vertebralcrushfracutres300,000hipfractures250.000wristfractures300,000otherfracturesPainOnly25-30%ofvertebralcompressionfracturespresentwithsuddenonsetbackpainChronicpainLossofheight,Humpbackkyphosis（humpback）Kyphosisismoreseverewithage24Vertebralbo
5、dyVertebralbodyheight2cmShort2mm，total3-6cmFracturesFracturesarethemostdangerousaspectofosteoporosisMultiplevertebralfracturesleadtoastoopedposture,lossofheight,andchronicpainwithresultantreductioninmobilityHipfracture,inparticular,usuallyrequirespromptsurgery,asthereareser
6、iousrisksassociatedwithahipfracture,suchasdeepveinthrombosisandapulmonaryembolism,andincreasedmortality.Aclassicalcaseofosteoporosismaystartinawomanabout55yearsofagewithawristfractureThoracicfractureareassociatedwithrestrictivelungdiseasesLumbarfractureareassociatedwithabdo
7、minalsymptomincludingdistension,earlysatietyandconstipationⅣDiagnosisanddifferentialdiagnosisBonemineraldensity（骨密度测定）MeasurementofbonemassDual-energyx-rayabsorptiometry(DXA,双能X线吸收法）ThegoldstandardformeasuringbonedensityMeasurementsofanysiteClinicaldeterminationsaremadeofth
8、espineandhipBonespurs,whicharefrequentlyinosteoarthritis,tendtofalselyincreasebone
