Osteoporotic

Osteoporotic is an adjective referring to osteoporosis or to conditions and changes caused by the disease. Osteoporosis is a systemic skeletal disorder characterized by reduced bone mineral density and deterioration of bone microarchitecture, which leads to increased bone fragility and a higher risk of fractures.

The condition is most common in older adults, especially postmenopausal women, though it affects men as well. Risk factors include advanced age, female sex, low body weight, family history, smoking, excessive alcohol use, insufficient calcium and vitamin D intake, physical inactivity, and certain medications such as prolonged corticosteroid treatment. Medical conditions that affect bone metabolism, including thyroid disorders and inflammatory diseases, can also contribute.

Osteoporotic fractures are a major concern because they often occur with minimal trauma. The most frequent sites are the hip, spine (vertebral fractures), and wrist. Vertebral fractures may cause back pain, height loss, and spinal deformities, while hip fractures can lead to substantial disability and increased mortality in older adults.

Diagnosis typically involves measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). A T-score of -2.5 or lower indicates osteoporosis, while -1.0 to -2.5 is termed osteopenia. Risk assessment tools, such as the FRAX model, help estimate fracture risk and guide treatment decisions.

Management focuses on reducing fracture risk through lifestyle measures—regular weight-bearing exercise, fall prevention, adequate calcium and vitamin D intake—and pharmacologic therapies. First-line medications often include bisphosphonates; other options include denosumab, selective estrogen receptor modulators, parathyroid hormone analogs, and newer agents. Prevention and early detection are key to maintaining mobility and quality of life in affected individuals.