Risk Stratification
Disease states that lead to calcium disturbances include the following:
This disease of the bone is characterised by low bone mass and micro-architectural deterioration of bone tissue. Bone is normally mineralised but deficient in quantity, quality and structural integrity. Oestrogen deficiency is a factor in both male and female. In the elderly vitamin D insufficiency, and secondary hyperparathyroidism may be the cause of osteoporosis.
Dual energy absorptiometry is diagnostic. Lifestyle advice (exercise, diet) and alendronate (bisphosphonates inhibit osteoclast resorption) may be used to decrease risk of hip and non vertebral fractures. Raloxifene has established efficacy in decreasing risk of vertebral fractures calcium and vitamin D supplementation is also required.
These disorders result from inadequate mineralisation of the bone matrix. Usually there is a defect in vitamin D metabolism. They can occur secondary to chronic renal failure.
Bone pain, tenderness and pathological fracture can occur. Proximal myopathy produces a waddling gait. Hypocalcaemic tetany is possible in severe cases.
A focal disorder of bone remodelling where initial excessive resorption is followed by excessive new bone formation. The new bone is structurally abnormal. The majority of cases defined by x-ray are asymptomatic. Common sites include pelvis, skull, femur and spine.
Cardiac hypertrophy and high output failure occur. Symptoms include bone pain, nerve compression and deformities with pathological fractures. Changes are shown in diagnostic section. Bisphosphonates are the mainstay of treatment.