Spotted osteoporosis: what it is, causes and symptoms, stages, diagnosis and treatment

What is patchy osteoporosis?

The disease provokes the destruction of bone tissue, resulting in an increased risk of bone fracture

There are two main types of osteoporosis: generalized (the entire skeletal system is affected) and local (the fragility of one particular bone increases). Local osteoporosis is divided, in turn, into spotty and uniform. These forms of the disease differ in the prevalence of the pathological process:

1. Uniform local osteoporosis affects the entire bone, causing uniform rarefaction of its structure. This process occurs gradually, the disease constantly progresses. This form of the disease is also called diffuse.
2. Spotty, or focal, osteoporosis affects individual, chaotically located areas of the bone. The x-ray shows round or oval foci of bone tissue with low density. The affected segments can have different sizes, shapes and outlines. With patchy osteoporosis, the bone size is maintained, but its structure in some places becomes porous, which leads to excessive fragility.

In the absence of treatment, focal osteoporosis most often turns into uniform osteoporosis, thus being its predecessor.

Osteoporosis most often affects women. Every third representative of the fair sex suffers from this disease. In some cases, the disease manifests itself at a relatively young age.

Exercise therapy

Although doctors often prescribe exercise therapy when a patient has back pain due to osteoporosis, it can be dangerous. In particular, you should not work with loads, because a fracture may occur. You should avoid putting stress on your joints at all costs. If you have a symptom such as an acute severe attack of pain, you should also avoid exercise therapy.

The procedure is prescribed if the patient has chronic pain. Exercises are needed to strengthen human muscles. The stronger they are, the less stress on the bones. It is increased stress that often causes pain.

Causes of development of patchy osteoporosis

The focal form of the disease refers to secondary pathologies, that is, it occurs against the background of any other ailments or malfunctions in the body. Among the most common causes are the following:

1. Post-traumatic osteoporosis. Develops as a result of injury.
2. Postoperative. The disease manifests itself as a result of surgical intervention.
3. Idiopathic. If specific causes of the disease have not been identified, then this is the form we are talking about.

In addition, the following factors can become indirect provocateurs for the development of the disease:

1. Genetic. If a person belongs to the Caucasian or Mongoloid race and one of his close relatives suffered from osteoporosis, then with a high degree of probability he may develop this disease. People with low weight are also at risk.
2. Hormonal. The disease often affects women during menopause. Focal osteoporosis can manifest itself against the background of hormonal imbalances and infertility.
3. Endocrinological. The disease can be caused by pathologies such as diabetes mellitus, hypocortisolism syndrome, in which the adrenal glands secrete too many hormones.
4. Taking certain medications. We are talking about glucocorticoids, anticonvulsants, anticoagulants, antibiotics, cytostatics.
5. Rheumatoid polyarthritis, Libman-Sachs disease, chronic circulatory failure.

Lifestyle can also provoke the development of rheumatoid polyarthritis. We are talking about insufficient physical activity, smoking and alcohol abuse, vitamin D deficiency caused by living in a cold climate. Persons with an asthenic body type are also susceptible to the development of patchy osteoporosis.

Causes

The pathology develops gradually. In the early stages, a person experiences mild pain and discomfort. However, over time, the bone head and glenoid cavity of the scapula undergo degenerative changes under the influence of mechanical or functional overload. The progression of the disease leads to the loss of firmness and elasticity of the cartilage. As a result, joint mobility is impaired.

Over time, more and more surrounding tissues undergo degeneration, and the pain becomes more severe, its character changes from periodic to permanent. This condition can be caused by:

• injuries;
• pathological processes in the musculoskeletal system;
• overweight;
• diseases of the thyroid or parathyroid gland;
• with a struggle in the functioning of the liver and kidneys;
• impaired metabolism;
• alcohol and drug abuse;
• low physical activity.

Hereditary predisposition and age-related changes in the body are also factors influencing the development of OPS. The latter includes changes in hormonal levels in women, and therefore the disease progresses at a faster rate in them than in men. Calcium is no longer absorbed by the body due to a decrease in estrogen levels.

Symptoms and stages of the disease

Symptoms of pathology make themselves felt only at advanced stages of development

The main danger of this disease is its unnoticed development over a long period of time. Most patients do not even suspect that they are sick, turning to a specialist when the disease is at an advanced stage.

Spotted osteoporosis can be treated with conservative methods in the first and second stages of its development. However, during this period the disease cannot be recognized even on x-rays. Therefore, even accidental detection of the disease at the initial stages of its development is almost completely excluded.

There are 4 stages of macular osteoporosis:

1. At the first stage, the disease does not have any symptoms. There are minor changes in the bone structure that cannot be detected by modern research methods.
2. In the second stage, mild discomfort may occur. X-rays often do not show changes in bone structure. Usually, when osteoporosis is suspected, more accurate methods are used, in particular densitometry.
3. In the third stage, the patient experiences significant pain that hinders his movements. It can be present not only during movement, but also at rest. Osteoporosis at the third stage is recorded on an x-ray.
4. The fourth stage is associated with disability. The patient experiences visual changes in the bone structure: poor posture, decreased height. The pain can become unbearable.

The main symptoms of patchy bone osteoporosis are:

• aching bone pain;
• fragility of nails;
• high degree of fatigue;
• convulsions at night.
• slouch.

Osteoporosis. The first signs of the disease. Who should I contact for advice?

The main cause of the disease is considered to be a violation of metabolic or metabolic processes in bone tissue. As a rule, treatment of osteoporosis comes down to slowing down the aging process of bones and establishing normal metabolism.

Osteoporosis is quite common in European countries and is common in ours. Moreover, statistics confirm that approximately 35% of women and 20% of elderly men suffering from causeless fractures suffer from this particular disease. The number of deaths associated with femoral neck fractures, vertebral compression fractures or other osteoporotic fractures increases every year.

How dangerous is the disease?

First of all, it is worth noting that osteoporosis can go undetected for a long time. After a certain age, and in women this is associated with menopause, metabolic processes in the body slow down, the bone structure loses calcium and fluoride, and the skeleton weakens. These metamorphoses do not cause any particular concern for patients and are perceived as normal aging of the body.

Minor signs of the disease (ache in the joints, dizziness, headache, back pain, the treatment of which is delayed) remain unattended for a long time and the first signal of osteoporosis becomes a fracture. For example, a compression fracture of the cervical spine occurs almost unnoticeably and painlessly, the treatment of which is quite long and this already indicates an advanced form of the disease. Pain syndrome appears after fractures and cracks have formed in several middle vertebrae.

Thus, patients turn to an osteoporosis treatment center too late, when the disease is already in an advanced form.

Possible causes of osteoporosis:

• Congenital genetic characteristics or predisposition (presence of the disease in close relatives).
• Old age (especially in women).
• Too fragile physique and low body weight, as well as too much height.
• Any hormonal imbalances, including menopause and infertility.
• Long-term use of medications that directly or indirectly affect the composition of bone tissue.
• Chronic diseases of the endocrine system, gastrointestinal, circulatory, as well as tumor formations, etc.
• Physically hard work or, conversely, weak physical activity.
• Bad habits (tobacco smoking, alcohol, abuse of coffee drinks).
• Poor or unhealthy diet.
• Inability to digest dairy products by the body, and, consequently, calcium deficiency.
• Lack of vitamin D and other microelements necessary for bone structure.

How to recognize osteoporosis before a fracture?

What symptoms should you pay attention to before a fracture occurs:

• Painful sensations in the back, especially when feeling the spine with your hands.
• Constant tension in the back muscles, noticeable limitation of motor ability (difficulty bending, turning, twisting the body).
• A sudden disturbance in posture, the appearance of stoop (Scheuermann-Mau disease, kyphosis) and a strong deflection of the spine in the lower back (lordosis), as well as the unexpected formation of skin folds on the sides of the abdomen.
• A later manifestation of the disease will be a decrease in body height (decrease in the height of the spinal column), when the length of the arm span exceeds the length of the body by more than 3 cm.
• A noticeable narrowing of the distance between the lower ribs and the arches of the wings of the ilium.

At the first sign of illness, go to the hospital. By conducting certain tests and diagnosing osteoporosis, your doctor will be able to prescribe the proper treatment for you and prevent unexpected fractures from occurring. In general, to avoid advanced disease, doctors recommend that middle-aged women and elderly people of both sexes undergo densitometry (determination of bone tissue density) every two years.

If the disease is discovered, the patient is prescribed a computer or magnetic resonance imaging scan, radiography and laboratory tests to check the level of calcium, vitamin D, phosphorus and other trace elements in the blood. In this case, X-rays will be effective when bone loss is more than 30%, but will help identify hidden vertebral compression fractures.

Which doctor should I contact to diagnose osteoporosis?

What kind of doctor specializes in diagnosing and treating osteoporosis? First of all, it makes sense to make an appointment with an osteopath or orthopedist; if they are not available, a surgeon or traumatologist can help. But let us reassure you right away: this disease is treated surgically very rarely. For surgery, there must be very compelling reasons related to severe pain, pinched nerve roots (loss of sensation in the limbs or immobilization of the body) or dysfunction of internal organs (urinary and fecal incontinence, impaired potency).

Osteoporosis is treated with special diets and pharmaceuticals. In this case, medications are prescribed when bone mass becomes completely critical or decreases sharply.

Drugs used to treat osteoporosis:

• medications containing calcium and its derivatives to prevent loss of bone density;
• anabolic drugs that regulate bone tissue restoration processes;
• antiresorptive substances that stop bone destruction;
• preparations containing vitamin D and other microelements.

In addition, there are other methods of treating osteoporosis. This includes traditional medicine (treatment with herbs, mumiyo, nuts, eggshells), therapeutic exercises and massages, treatment with manual therapy methods, etc.

And to prevent the disease, experts recommend:

• daily receive proper and balanced nutrition containing sufficient amounts of calcium, phosphorus, sodium and trace elements;
• follow your daily routine (full sleep, walks in the fresh air and sunbathing) so that vitamin D is produced naturally in the body;
• lead a physically active lifestyle;
• give up bad habits and eat as little salt as possible;
• Eat enough dairy products and foods containing protein.

Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Diagnosis of patchy osteoporosis

If there is a suspicion of spotted osteoporosis, it is necessary to undergo a full examination and tests

To make an accurate diagnosis, a specialist relies on the following factors:

• presence of risk factors in the patient's medical history;
• general examination data;
• presence of bone pain.

If, after examining the patient, the doctor suspects osteoporosis, he will prescribe additional laboratory and instrumental tests. These include:

• densitometry;
• radiography;
• CT scan;
• biochemical blood and urine tests;
• MRI.

If the patient complains of pain in a specific area, then the examination should primarily focus on examining the painful area. For example, X-rays of the hip or wrist joints and spine are performed.

Prevention

The first step in preventing the disease is timely contact with a highly qualified specialist. This must be done as soon as the first discomfort and minor pain in the joints appears. People who are included in at least one of the risk groups need to undergo preventive densitometry annually and have their blood tested for calcium content. This analysis should also be taken on a regular basis in case of long-term treatment with glucocorticosteroids and hormones.

Preventive measures also include avoiding the abuse of alcoholic beverages, maintaining proper nutrition with the inclusion of calcium-rich foods in the diet, as well as regular exercise and light exercise. You should definitely pay attention to your weight and prevent the appearance of extra pounds. Consumption of caffeinated drinks should also be limited and, if possible, eliminated altogether. Constant walks in the sun within reasonable limits and in compliance with safety rules will also have a positive effect.

Features of treatment

The course of treatment for spotted osteoporosis is determined by a traumatologist. Depending on the degree of bone tissue damage, the patient is prescribed individual therapy. This treatment has several goals:

1. If the development of osteoporosis is a consequence of the progression of another disease, then it should be treated first.
2. Enrichment of bones with essential vitamins and calcium to prevent increased fragility.
3. If necessary, the affected joints are replaced.

Complex treatment includes the following areas:

1. Drug therapy. It is the basis for the treatment of spotty osteoporosis of the foot bones, but it does not always have the expected effectiveness. Taking medications is usually aimed at eliminating the underlying cause of the disease and replenishing calcium reserves in the body.
2. Exercise therapy. Training ligaments and tendons, as well as exercises that increase muscle mass, can prevent bone fragility. A properly composed set of exercises creates optimal conditions for recovery from the disease.
3. Massage treatments. Massage for osteoporosis should only be performed by a professional, since improper massage can cause damage to brittle bones. When a massage course is carried out correctly, good results can be achieved.
4. Folk remedies. In folk medicine, recipes based on onion peels and eggshells are widely known, helping to enrich the body with calcium. It should be understood that such methods will not be enough to cure such a serious illness, but they can improve the results of treatment using official medicine.
5. Diet. Patients with patchy osteoporosis should avoid fried, peppered, fatty, and salty foods. It is advisable to refrain from drinking alcohol and smoking. An individual diet is determined by the attending physician.
6. Joint replacement. This is an extreme measure that is used only when conservative methods have not produced tangible results.

Electrotherapy

It is important not only to understand the pain associated with osteoporosis, but also to choose the appropriate method of physical therapy. One of the areas is electrotherapy. During the session, the tissue begins to be affected by an electric field. This is aimed at warming the skin, stimulating blood circulation and metabolism.

Among the limitations in using the method is the presence in the patient’s body of a pacemaker or various metal products that could resonate with the created field.

How to diagnose

At your first visit, your doctor will examine and feel your knee joint to determine the cause of the disease. A specialist may prescribe the following procedures:

• X-ray. The images allow us to determine the presence of osteophytes and irreversible processes in cartilage.
• Absorptiometry. Examination of the knee using two x-rays, revealing bone density and the area of ​​dangerous changes.
• Biochemistry of blood. Allows you to determine disruptions in the metabolism of calcium and hormones of the female reproductive system.

Sometimes a specialist sends a patient to undergo an MRI in order to identify the nature of changes in the bones.