Osteopenia is borderline with osteoporosis, densitometry indicators. How to treat osteopenia. Preparing for the study

Often, as people age, their bones become more brittle. And an ordinary fall threatens them with a severe fracture of not only their arms, legs, but also their spine. Doctors send such patients for examination and, based on the results, establish a diagnosis of osteopenia or osteoporosis. What kind of diseases are these? And how do they differ from each other? What is the prognosis for each disease?

Definition

If we translate the term osteopenia literally, it will mean a lack of bone tissue, or, more precisely, its main component - calcium. In medicine, osteopenia is a decrease in bone mineral density compared to generally accepted maximum standards. However, unlike osteoporosis, density values ​​do not become pathologically low.

Osteopenia of the lumbar spine often leads to fractures of the vertebral bodies even with minor injuries - a fall from a small height, a sharp jump. If this condition is not diagnosed in time, osteoporosis may develop - a systemic disease. With osteoporosis of the lumbar spine, compression fractures of the vertebral bodies occur - without injury or physical stress, under the influence of the weight of the human body. In this situation, patients experience the following symptoms:

• Pain in the lumbar region, and sometimes throughout the entire spine.
• Impaired motor activity, lameness, difficulty going down and going up stairs.
• Neurological disorders are also possible - decreased sensitivity, weakness in the legs.

Can osteopenia be cured?

Treatment

Since osteopenia is not a full-fledged disease, it is not treated in the literal sense of the word. The task of the doctor and the patient is to slow down its progression. It is very important to prevent the transition of osteopenia to osteoporosis, because it will require completely different, more complex treatment. And osteoporosis therapy is not always successful.

How to deal with osteopenia? How can you strengthen the skeletal system – limbs and spine? The tactics of action will depend on the cause of this syndrome.

The main measures for osteopenia are as follows:

• Physiotherapy.
• Taking calcium supplements and vitamins.
• Correction of hormonal therapy.

Diet

A nutritious diet is an important step in the fight against osteopenia, especially when it affects the hip bones and spine. It must be balanced in essential substances, vitamins and microelements. Particular attention is paid to sufficient protein content in the diet, because it is consumed when modeling the skeletal system.

In addition, the minerals phosphorus, calcium and magnesium are important. For better digestibility, it is advisable to include vitamin D3 in the diet.

What foods are rich in these microelements? Calcium is found in milk, cheese, sour cream, cottage cheese, kefir, yogurt, and feta cheese. But, in addition to dairy and fermented milk products, there is a lot of it in plant foods - cabbage, parsley, spinach, dandelion leaves, grapefruits, tangerines and bananas. In addition, it is advisable to eat different types of nuts - cashews, hazelnuts, almonds, pistachios, peanuts, pine nuts and walnuts. They are rich not only in calcium, but also in magnesium.

Magnesium is also found in peas and beans, buckwheat, oatmeal, barley, mustard, and seaweed.

In order for the body to have enough phosphorus, you need to enrich your diet with fish, crab meat, squid and other seafood. There is a lot of it in fermented milk products - cottage cheese, feta cheese.

However, even with an adequate dietary intake of calcium, magnesium and phosphorus, the skeletal system will suffer if the body does not receive enough vitamin D3. It is prescribed to children in capsules to prevent rickets. But it is also found in food:

• fish oil;
• herring;
• egg yolks;
• pork and beef liver.

In addition, it can be synthesized in the body under the influence of sunlight. That is why long walks in sunny weather strengthen the health of the entire body and the skeletal system in particular.

Physiotherapy

If motor activity is impaired, it is recommended under the guidance of an instructor. Movement is life for muscles, joints and bones. Prolonged immobilization leads first to reversible and then irreversible osteopenia. The outcome of these conditions is usually systemic osteoporosis with pathological fractures. This situation is especially dangerous in relation to fractures of the femoral neck and spine.

It should be remembered that with osteopenia, the bones can only withstand the usual load, but they are not able to cope with excess load.

Therefore, physical therapy begins with the simplest and easiest exercises. And only as the bones, ligaments and muscles become stronger, the exercises become more difficult. In case of osteoporosis, exercise therapy should be even more gentle, since the risk of pathological fractures is high.

Calcium supplements and vitamins

Is it necessary to take calcium and vitamin supplements for osteopenia? Yes, this is an excellent remedy to stop the progression of the osteopenic process. Moreover, calcium supplements and vitamins are currently recommended for most women after 65 years of age, since it has been proven that almost everyone experiences osteopenia during menopause.

What calcium preparations are common in pharmacies today? The most well-known medications prescribed by doctors for the treatment and prevention of osteopenia or osteoporosis:

• Calcium carbonate.
• Calcium gluconate.
• Vitrum osteomag.
• Calcium citrate.
• Kalcemin and Kalcemin Advance.
• Calcium D3.
• Calcium Sandoz forte.
• Calcium lactate.

Many of these products contain not only calcium, but also magnesium, phosphorus and other minerals, as well as vitamin D3.

Correction of hormonal therapy

If osteopenia, and subsequently osteoporosis, has developed while taking steroid hormones, it is necessary to reconsider the treatment regimen. This complication is typical for long-term therapy of autoimmune diseases - systemic lupus erythematosus.

Sometimes osteopenia is a consequence of dishormonal diseases - thyrotoxicosis, hyperparathyroidism. In this case, special hormonal treatment is prescribed to correct the function of these glands - the thyroid and parathyroid. Also, replacement therapy is carried out for women in menopause, which helps the body restore its hormonal levels and at the same time inhibits the development of osteopenia.

Osteopenia is not a death sentence, but only a reason to be examined in a timely manner and take preventive measures. As a rule, changing your diet and taking calcium supplements is enough to prevent the development of osteoporosis.

Osteopenia is a condition characterized by a decrease in bone density, its rarefaction. As a result, bones become more fragile and susceptible to fractures.

Since decreased bone density can occur in a variety of diseases, the term “osteopenia” refers to a group of diseases that includes osteoporosis, osteomalacia, and others. In some cases, osteopenia may be a normal variant.

Development mechanisms

During a person’s life, bone tissue, like most others, constantly undergoes self-renewal: old cells die and are removed from the body (resorption process), new ones appear in their place (synthesis process). Complete renewal of the tissue of various skeletal bones of an adult takes on average from one to twelve years. Synthesis and resorption are components of one process - bone tissue metabolism.

Osteoblast cells are responsible for the synthesis (formation) of bone tissue, creating the organic framework (matrix) of bone tissue and ensuring its mineralization with inorganic substances - calcium and phosphorus. The function of osteoclast cells, on the contrary, is to destroy bone tissue.

The main factors influencing bone metabolism:

• the amount of building material for bones - calcium, phosphorus to give bone hardness and proteins to form an organic frame (matrix);
• digestibility of this building material;
• calcitriol level;
• parathyroid hormone level;
• calcitonin level;
• level of sex hormones.

Osteopenia is a consequence of organ dysfunction, leading to changes in the listed factors.

Good absorption of calcium and phosphorus is due to:

• normal functioning of the digestive system;
• adequate fat intake;
• sufficient amount of vitamins D.

Vitamins of group D, which enter the body with food or are synthesized in the skin under the influence of ultraviolet radiation, are precursors of the hormone calcitriol. These vitamins are fat-soluble, so they cannot be absorbed in the absence of fat in the diet.

Calcitriol is formed from vitamins D, mainly in the kidneys. This hormone performs the following functions:

• promotes the absorption of phosphates and calcium in the intestine;
• stimulates the activity of osteoblasts and osteoclasts;
• stimulates bone mineralization;
• suppresses the synthesis of parathyroid hormone.

Parathyroid hormone, or parathyroid hormone, is produced by the parathyroid glands. Its functions:

Calcitonin is synthesized by the thyroid gland. This hormone reduces the activity of osteoclasts, providing increased bone mineralization.

Female sex hormones - estrogens - activate osteoblasts. Androgens (male sex hormones) help increase bone mass.

Thus, slowing down the formation of bone tissue and/or accelerating its resorption is most often due to:

• deficiency in the diet of calcium, phosphorus, proteins, fats, vitamins D, as well as deficiency of ultraviolet exposure;
• dysfunction of the digestive system;
• decreased production of calcitriol, calcitonin and sex hormones;
• increased synthesis of parathyroid hormone.

Other factors leading to decreased bone mass:

• vitamin C deficiency;
• change in acid-base balance towards a decrease in pH (acidosis);
• increased levels of thyroid hormones secreted by the thyroid gland;
• almost complete exclusion of physical activity;
• and a rare factor - the state of weightlessness.

Maximum bone mass is recorded at the age of thirty. Then it starts to decline.

Reasons for the development of osteopenia

The disease most often develops against the background of the following pathological (abnormal) and physiological (normal) conditions:

Other factors provoking the development of the disease:

• alcoholism;
• smoking;
• prolonged bed rest or inactivity due to other reasons;
• treatment with corticosteroids for three or more months;
• long-term treatment with anticoagulants (drugs that increase blood clotting time);
• long-term use of antacids (drugs to reduce stomach acidity);
• chemotherapy and radiation therapy.

In addition, the likelihood of early development of osteopenia of the osteoporosis type increases the relatively low mass of bone tissue at the age of thirty. Risk factors for this condition include:

Types of osteopenia

The most common types of osteopenia are:

• osteoporosis;

Often, patients experience both types of osteopenia at once.

Osteoporosis

Osteoporosis is characterized by inhibition of the activity of osteoblasts, as a result of which a decrease in bone mass occurs both due to the loss of the organic framework and due to a lack of mineralization.

With osteoporosis, bone structures - the so-called beams - become thinner. Thinning leads to their perforation and fractures, resulting in increased bone fragility.

Most often, osteoporosis develops against the background of hypoestrogenism - a decrease in estrogen production. The disease develops in postmenopause (after 50 years) or earlier, with drug stimulation of artificial menopause, removal of the ovaries or early extinction of their function.

Another common form is senile osteoporosis, which occurs on average after 70 years of age. This form is associated both with a general decline in the activity of factors that stimulate bone formation, and with the addition of diseases against which osteopenia develops. Inactivity makes the situation worse.

Osteomalacia

With osteomalacia, matrix formation is not impaired (and may even be increased), but calcium and phosphorus are washed out of the bone. At the same time, the bones “soften”, which leads to their deformation and increased fragility.

This type of osteopenia is associated with a lack of calcium, phosphorus and vitamins D. The main causes:

• nutritional (food deficiency);
• malabsorption.

The nutritional form, associated with a deficiency of calcium and vitamin D, usually occurs in children.

Other conditions accompanied by decreased bone density:

• fibrocystic osteitis - increased resorption of the matrix and inorganic substances with replacement of the affected area with fibrous tissue; this type is associated with an increase in parathyroid hormone and occurs against the background of diseases of the parathyroid gland;
• hypostoses associated with hereditary and congenital diseases, as a result of which a deficiency of bone tissue mass begins in childhood and adolescence - at the stage of skeletal growth;
• physiological age-related bone atrophy (a variant of the norm), in which, along with the rarefaction of some structures, an adaptive strengthening of others occurs, as a result of which fractures can be observed no more often than in the population.

There are primary and secondary osteopenias. Primary osteopenia develops against the background of hypoestrogenism, nutritional reasons, due to old age. Secondary is associated with the underlying disease, which indirectly caused bone loss.

Symptoms

Osteopenia is often asymptomatic, including with significant damage to bone tissue (this is especially true for osteoporosis; osteomalacia is often accompanied by severe pain). Even vertebral fractures caused by their crushing under their own weight may not cause acute pain. There are no specific symptoms either; sometimes osteopenia is accompanied by the following signs:

• aching pain in the lower back and sacrum;
• muscle weakness;
• general fatigue;
• shuffling gait.

As the process progresses, back pain becomes intense and constant, and also includes:

Spontaneous bone fractures are those that occur under the influence of a minor impact that is not usually capable of leading to a fracture. Such fractures are a typical sign of osteopenia.

The most serious is a fracture of the femoral neck. It is not the fracture itself that is dangerous, but the complications associated with prolonged immobility: pneumonia, thrombosis.

How does a doctor make such a diagnosis?

The diagnosis is established according to hardware and laboratory tests.

Hardware diagnostics

Modern methods for diagnosing osteopenia:

• dual-energy x-ray absorptiometry (DXA), or x-ray densitometry;
• ultrasonic densitometry.

Ultrasound examination is the safest for health, but less accurate than DXA. Regular ultrasound diagnostics is recommended for representatives of risk groups:

• men and women over 65 years of age;
• at an earlier age - for women with early onset (before 45 years) menopause;
• regardless of gender and age - to persons with spontaneous fractures and/or risk factors for osteopenia in history.

If osteopenia is suspected based on ultrasound results, DXA is prescribed to confirm the diagnosis. DXA has a criterion by which the severity of osteopenia can be judged. If the value of this criterion is less than -2.5, this indicates severe damage to bone tissue.

Laboratory diagnostics are used to determine the type of osteopenia.

Laboratory methods

Laboratory tests are used both to diagnose osteopenia and to evaluate the effectiveness of prescribed treatment. Such tests include:

• Urine deoxypyridinoline is one of the collagens of the bone matrix;
• blood tests:
  • activity of the bone isoenzyme alkaline phosphatase – a marker of active osteoblast division;
  • Osteocalcin is the main collagen protein of the bone matrix;
  • Beta-Cross laps is a marker of bone resorption;
  • P1NP – marker of bone metabolism;
  • parathyroid hormone, calcitonin, calcitriol – markers of hormonal regulation of bone metabolism;
  • calcium, vitamin D - indicate insufficient consumption or malabsorption.

In some cases, it is necessary to resort to a biopsy - taking a small piece of bone tissue and examining it under a microscope.

Treatment

First of all, it is necessary to eliminate risk factors (in secondary osteopenia, this is the treatment of a disease that has caused changes in bone tissue). If this opportunity presents itself, osteopenia will be completely cured. Unfortunately, this is not always possible.

The treatment is complex and includes the following measures:

• therapeutic exercises, walking (with a gradual increase in load);
• smoking cessation;
• diet;
• use of medications;
• with significant damage - wearing corsets and bandages to avoid fractures.

Diet

The diet can completely cure nutritional osteomalacia, and also contributes to some improvement in the formation of bone tissue in osteoporosis.

Basic principles of the diet:

Details of dietary nutrition should be discussed with your doctor, who will help you choose the optimal diet depending on your individual characteristics.

Principles of drug treatment

For postmenopausal and senile osteoporosis, medications are usually prescribed only when the X-ray densitometry criterion value is less than -2.5. Drug treatment of osteoporosis allows you to temporarily stop the process and accumulate bone mass, after which the disease proceeds without fractures or other complications for a certain period.

Completely different medications are used to treat osteoporosis and osteomalacia. In addition, their choice depends on the root cause that caused the changes in bone tissue.

Treatment should be prescribed by a doctor after establishing a final diagnosis and subject to careful monitoring of the patient. Since most medications for the treatment of osteopenia are not harmless, self-medication can lead to serious consequences.

About the dangers of self-medication

Some people, having come up with a diagnosis for themselves, prescribe treatment themselves, especially since media advertising claims the unprecedented effectiveness and safety of some drugs.

Let's take the same Calcium D 3 - a calcium preparation with vitamin D. Firstly, long-term use of this drug can lead to hypercalcemia - an increase in calcium in the blood serum, with severe complications in almost all organs and systems. And the use of this “harmless” drug while taking corticosteroids and for six months to a year after their withdrawal can lead to the formation of kidney stones.

Uncontrolled use of estrogen-containing drugs recommended for the treatment of postmenopausal osteoporosis significantly increases the likelihood of developing hormone-induced malignant tumors - endometrial and breast cancer.

This list can be continued endlessly.

Prevention

Prevention of osteopenia should begin long before the age of thirty in order to achieve the accumulation of the maximum possible bone mass. To do this, the following rules must be observed:

• limit smoking (it is better to completely stop or not start) and drinking alcohol;
• regularly devote time to walks in the fresh air and exercise;
• limit heavy physical labor (including sports activities);
• during pregnancy and lactation - prevention of calcium deficiency (only as prescribed by a doctor);
• adhere to a balanced diet, refuse mono-diets and diets with a sharp restriction of any nutrients (unless this is a therapeutic diet prescribed by a doctor);
• Stay in the sun for at least 10 minutes every day.

Even if the disease cannot be cured completely, the measures listed will be useful in the case of already developed pathology - they help slow down the process.

Both pathologies are characterized by changes in the structure of bone tissue. What then is the difference between osteopenia and osteoporosis? What signs and symptoms are characteristic of each pathology? Are there any specifics to their treatment? We will answer these and many other questions as fully as possible.

Osteopenia is a precursor to osteoporosis

Osteopenia is a condition in which bone loses mineral density. Changes in structure and mass make bones more vulnerable to excessive stress, resulting in an increased risk of fractures from minor mechanical stress - a symptom that is characteristic of osteoporosis.

Simply put, with osteopenia, a person’s risk of bone fracture increases, and with osteoporosis, a fracture can occur even from a slight blow.

Thus, the main difference between the pathologies is that osteopenia is the initial stage of bone tissue destruction, which without proper treatment will develop into such a serious disease as osteoporosis.

The most vulnerable areas of the skeleton in osteopenia and osteoporosis are:

• vertebrae (if you fall on your side or back);
• shoulders and forearms (fall on the outstretched arm);
• tibia;
• femoral neck.

Symptoms and causes

It is not possible to clearly demonstrate the difference between osteopenia and osteoporosis using symptoms. Pathologies have approximately similar manifestations, and most often osteopenia is detected already when the first compression fracture occurs, the prerequisites for which, it seems, were not there. Or a violation of the structure of bone tissue is revealed on an x-ray, which was taken to diagnose completely different problems.

Only a thorough analysis of all symptoms, knowledge of the patient’s medical history and lifestyle, and recording of medications consumed in the presence of chronic pathologies will allow the doctor to make a preliminary diagnosis - osteopenia or osteoporosis.

An experienced therapist who has been observing the patient preventively for many years (for Russia, this situation still remains a fantasy) can point out the first symptoms of bone problems:

• decrease in height (occurs due to a reduction in the height of the vertebrae) and poor posture;
• difficulties in performing habitual actions during which a person wants, for example, to sit down or get up from a chair;
• pale skin and lack of tan (the person has stopped spending time in the fresh air);
• the fingers began to look like “wax”.

Painful symptoms are especially pronounced in the morning, but during the day they may intensify due to excessive physical exertion. An exacerbation of the condition usually lasts up to a week.

The reasons why bone tissue changes structure in both pathologies are similar:

• bad heredity;
• bad habits and sedentary lifestyle;
• endocrine diseases;
• chronic bone pathologies;
• long-term use of a number of medications (cytostatics, glucocorticoids, antibiotics, including the tetracycline group).

The risk group includes:

• women over 40 years of age;
• aged people;
• people with tall stature (women - more than 173 cm, men - more than 183 cm);
• people who are underweight (anorexics);
• patients suffering from intolerance to a number of products, including dairy.

In women over 35 years of age, the likelihood of fractures is higher, since physiologically their bone density is initially lower than that of men.

Osteopenia can also be caused by:

• hormonal imbalances, including after menopause or in the presence of diabetes;
• excessive consumption of alcohol and coffee;
• living in regions with a lack of sunlight, in which the body does not receive enough vitamin D;
• long-term artificial nutrition, including after organ transplant operations.

Diseases that can cause osteopenia:

• diseases of the digestive system, accompanied by impaired absorption of minerals;
• pathologies of the blood vessels and circulatory system with impaired transport functions of nutrients;
• allergies;
• systemic pathologies of connective tissue;
• malfunction of the kidneys and liver.

A typical patient with osteopenia is a woman over 45, short, overweight, who has undergone surgery to remove internal organs, and who eats poorly because she lives alone.

Diagnosis, treatment and prevention

Unfortunately, X-rays do not always help to identify what pathology is destroying the patient’s bones - a borderline state of osteopenia with its high risk of fractures, or we are talking about osteoporosis.

If relatively recently medicine had to be content with X-ray studies, then Today, densitometry or dual-energy X-ray absorptiometry is used.

The results of densitometry are two indicators - Z and T.

• Z is the theoretical difference between the condition of the patient’s bone tissue and the norm, which is typical for a person with similar physiology (age, body weight, height);
• T is a practical indicator of whether the patient's bone density matches the norm.

At norm T is equal to minus one. For osteopenia – from minus 1 to minus 2.5. For osteoporosis – more than minus 2.5.

In addition, it is used:

• biochemical diagnostics, which allows you to record deviations from the norm in calcium metabolism and the level of hormone activity;
• To exclude multiple myeloma (a blood disease belonging to the group of leukemia), a biopsy specimen (a sample of bone tissue during a biopsy) of the ilium is examined.

Without proper treatment, osteopenia will sooner or later develop into osteoporosis, in which fractures can occur from any awkward movement.

Osteopenia (and, undoubtedly, osteoporosis) is especially dangerous in old age, when the chances of getting a femoral neck fracture increase many times over. This injury is practically a death sentence. A bedridden person most often dies from congestive pneumonia.

During the development of osteopenia, neuralgic pathologies arise when a person tries to limit mobility both because of the pain present and because his body simply cannot move in its usual rhythm.

Multiple rib fractures are caused by one of the types of pathology - steroid (postmenopausal) osteoporosis.

To successfully combat osteopenia and osteoporosis, bone structure should be controlled by supplying the body with the required amount;

• phosphorus;
• calcium;
• vitamins D, A, C, E, K;
• magnesium;
• silicon;
• manganese;
• boron;
• fluorine;
• zinc;
• copper

The body's need for each substance is determined as a result of laboratory tests.

You can compensate for the lack of vitamins and minerals by adjusting your diet with the obligatory inclusion of fermented milk products, or by taking vitamin-mineral complexes, which are agreed upon with your doctor.

If we talk about drug treatment, the emphasis is on eliminating the cause that causes osteopenia. For example, if the absorption of nutrients from food is impaired, then digestion is restored. If there is a real threat of transition of osteopenia to osteoporosis, then hormonal drugs and drugs from the biophosphonate group are prescribed. These medications put serious pressure on the body and often lead to complications, so their use is monitored daily by a doctor, for which the patient is sent to hospital treatment.

Having analyzed the causes of the development of osteopenia and osteoporosis, the differences of which lie only in the degree of destruction of bone tissue, it is easy to remember preventive measures:

• regular, healthy and balanced diet with mandatory consumption of foods containing calcium;
• moderate sun exposure resulting in a light tan;
• regular physical activity, taking into account age and capabilities - this could be work in the country or hobbies such as dancing, fitness, tourism;
• rejection of bad habits;
• regular examinations at a medical facility.

If you don’t start osteopenia, you won’t be able to get acquainted with osteoporosis. Don’t be afraid to “disturb” the doctor with your visit, because by starting timely treatment, you can quickly restore the structure of bone tissue and avoid serious fractures.

Video "Difference between osteopenia and osteoporosis"

Osteopenia is a pathological condition accompanied by a decrease in bone mineral density. As the disease progresses, it leads to osteoporosis. It is difficult to diagnose, since pathological changes in the bones, causing a decrease in the content of calcium and phosphorus in them, cannot be detected using laboratory methods and densitometry.

However, there are factors and diseases that are highly likely to be associated with osteopenia. Doctors recommend prevention of decreased bone density.

Why does the disease occur?

Numerous clinical studies conducted in all countries of the world have not identified a reliable cause of the disease. It is obvious that the pathology is formed as a result of metabolic disorders and increased destruction of the bone structure.

Osteopenia in children appears due to congenital abnormalities of the genetic structure with hereditary predisposition. It appears due to a lack of vitamin D during artificial feeding.

Pathogenetically, at the age of 30, gradual bone destruction is observed. The body uses them as a depot when there is a lack of calcium intake from food. This microelement is necessary for the functioning of muscle tissue and the heart.

The physiological process of bone resorption (destruction) is performed by osteoclasts (destructive cells). Osteoblasts are responsible for osteogenesis. If an imbalance occurs between these cells in favor of osteoclasts, osteopenia and then osteoporosis are observed.

It is obvious that when metabolism changes, the physiological process of osteogenesis (bone tissue formation) can be disrupted.

This is roughly how the mechanism of occurrence of this pathology is explained.

Osteopenia in children (including premature babies) is observed when:

• inflammatory diseases of the gastrointestinal tract with impaired penetration of calcium, phosphorus and vitamin D3 (chronic nonspecific colitis);
• the use of drugs with resorptive side effects (tetracycline);
• exposure to ionizing radiation.

Modern doctors have a special attitude towards drinks such as Coca-Cola and Pepsi. They destroy teeth and bones. With prolonged and frequent use in children, osteoporosis is observed. This fact has been proven by many clinical studies.

Diagnostic methods

Ultrasound and X-ray densitometry is determined by a decrease in the density of the bone structure in osteoporosis. The essence of the study is to pass rays (ultrasonic or x-ray) through a certain area. Due to reflection and absorption, a decrease in bone density can be detected.

Nevertheless, some private clinics, using modern equipment, can diagnose the disease and prescribe adequate treatment. There is a method of dual-energy absorption x-ray. It can be used to determine the loss of bone mineral composition at a rate of about 2% per year.

In public medical institutions, pathology is identified based on clinical symptoms. The first signs of the disease can be detected in patients with the following characteristics:

1. women over 55 years of age;
2. aged people;
3. Caucasian origin;
4. thinness;
5. frequent intake of adrenal hormones - glucocorticosteroids;
6. smoking;
7. sedentary lifestyle;
8. lack of vitamin D and calcium;
9. alcohol abuse.

If you have at least two of the above criteria, you are likely to have osteopenia.

In men, pathology is detected less frequently, since they have more pronounced bone and muscle mass. However, after the onset of menopause, hormonal levels are disrupted, so resorption processes prevail over osteogenesis. For this reason, in old age the disease is detected with equal probability in men and women.

For old people, osteopenia of the spine with damage to the lumbar region is specific. Radiculitis, intervertebral hernia, widespread osteochondrosis and spondylosis are frequent concomitant diseases with osteopenia.

Although systemic bone degeneration is not common in children, it occurs in 5%. The cause of the pathology is hereditary conditions associated with impaired calcium-phosphorus metabolism.

Prevention of the disease consists of following the following recommendations:

• Replenishment of calcium, phosphorus and vitamin D deficiency.
• Active physical activities.
• Power control.
• Rejection of bad habits.

Doctors compensate for calcium deficiency with medications. In addition, regular consumption of milk during minor signs of the disease helps prevent its progression.


Taking calcium supplements with food can partially compensate for the deficiency of this microelement, but their high cost does not justify the benefits. Crushed eggshells added to food will also be useful.

At the same time, we should not forget about the need to add vitamin D to the diet. It is formed in the skin under the influence of ultraviolet radiation, so you should be in the sun more often.

Physical exercise plays a significant role in maintaining bone mass. Bone tissue grows under the influence of muscle loads. If muscles are actively developing, they pull bones along with them. This is how physiological osteogenesis occurs. Therefore, to build bones, you need to exercise.

Signs of osteopenia are detected in older people when bone density is more than 2 during densitometry. In this case, old people have deformation of the lumbar spine. Its changes can be detected by radiography. In pictures of the lower back, in addition to specific changes in the vertebrae, a decrease in their density will be observed. A qualified radiologist will determine the disease “by eye”.

Criteria for densitometric diagnosis of osteopenia:

1. if the density indicator is less than 1 – normal;
2. from 1 to 2.5 – osteopenia;
3. more than 2.5 – osteoporosis.

Diet for osteopenic changes in the vertebrae

A diet for illness involves eating fruits, herbs and vegetables. Cow's milk and dairy products (cottage cheese, yogurt, fermented baked milk, kefir) are beneficial.

Magnesium helps increase bone density. It is found in beans, vegetables and grains. To prevent rapid thinning of bones, it is recommended to regularly perform gymnastics. Doctors advise running to build bone mass in the lower extremities.

Treatment of the disease with pharmaceutical drugs is carried out only when osteopenia transitions to osteoporosis.

Drug treatment for calcium deficiency in bones

Osteopenia is treated with cheap drugs that can be found in pharmacies.

Here are the most common of them:

• bisphosphonates;
• calcitonin;
• calcitriol;
• raloxifene;
• teriparatide.

Bisphosphonates are prescribed to prevent bone resorption. We draw the readers' attention to the fact that these medications do not promote osteogenesis. They only prevent bone destruction.

If a person regularly takes bisphosphonates, osteoclasts cannot perform their function. Therefore, they can only be taken for a short time. According to experimental studies, long-term blocking of bone resorption can lead to cancerous transformations of bone cells. In such a situation, a favorable prognosis for osteopenia is replaced by a threat to the patient’s life.

Calcitonin is a thyroid hormone that regulates calcium metabolism in the body. With its deficiency, resorption predominates over osteogenesis. Calcitonin obtained from sea salmon is used for administration to humans. The structure of this substance is similar to that of humans.

Raloxifene is a drug that activates estrogen. When used, the sensitivity of bones to estrogens (female sex hormones) increases, which increases bone mass.

Calcitriol is a vitamin D preparation. It contains a high concentration of this substance, so it is sold by prescription. When using the medicine, calcium levels should be constantly monitored.

Treatment with teriparatide is prescribed by an endocrinologist. The medicine belongs to the group of anabolic metabolism stimulants. In case of an overdose, a resorptive effect is observed.

Thus, osteopenia is the initial stage of osteoporosis. If its treatment is started in a timely manner, the prognosis is favorable in terms of preventing systemic leaching of calcium ions from the bones.

The most complete answers to questions on the topic: “osteopenia of the hip joint, symptoms and treatment.”

Osteoporosis of the hip joint is a disease that occurs as a result of metabolic disorders in the body, which leads to the destruction of bone tissue. Localization of the disease occurs in places subject to heavy loads. It is because of constant mobility that the hip joint is most often subject to injury and destruction.

Osteoporosis is a consequence and cause of skeletal injuries; the difficulty of treatment usually lies in extensive bone damage. In addition to the hip joint, the disease affects nearby bones, cartilage, ribs and spine.

Against the background of osteoporosis, the femoral neck is subject to resolution, violations of which immobilize a person and, without treatment, lead to death.

Reasons for appearance

Osteoporosis of the hip joint, like osteoporosis of other bones, is a common phenomenon and occurs for a number of reasons. Wear and tear of bone tissue and, as a result, osteoporosis, causes a number of disorders:

• Hormonal disorders, decreased estrogen production during menopause in women;
• Endocrine diseases;
• Lack of substances and vitamins due to poor nutrition;
• Bad habits – alcohol addiction and smoking;
• Hereditary factor;
• Taking medications;
• Long-term use of immunosuppressants;
• Age-related changes;
• Removal of organs of the female reproductive system and administration of artificial hormones.

Symptoms and signs

The main signs of osteoporosis are considered to be pain and discomfort in the affected area.

The pain occurs gradually and intensifies after physical activity. Afterwards, the pain does not go away for a long period, even at rest. Gradually, muscle tissue atrophy occurs and, as a result, motor activity decreases every day.

On the affected side, there is shortening of the joint and deformation, which is expressed by lameness.

As the disease progresses, it disrupts the functioning of other body systems; first of all, forced inaction suppresses mood and nervous disorders appear. Feelings of depression, weakness and general malaise accompany the development of osteoporosis.

One type of disease that primarily affects older people is diffuse osteoporosis. It is distinguished from other species by damage not only to one joint, but to all parts of the human skeleton.

At the beginning of its development, this form does not manifest itself in any way, no pain is observed. Bone tissue loses its density, only regular fractures and increased bone fragility are signs of diffuse osteoporosis.

Degrees of osteoporosis of the hip joint

There are three degrees of development of the disease based on the nature and severity of the course.

1st degree

This is the initial stage of osteoporosis, which is characterized by the appearance of a slight narrowing of the joint lumen. Like the first osteophytes, the fissures can be detected on an x-ray.

Symptoms include the appearance of pain during physical activity, which goes away at rest.

This stage, without complications and deep damage to the joint, responds well to treatment.

2nd degree

Progresses with severe pain that does not go away, the joint begins to lose mobility. The inflammatory process in the soft tissues and swelling does not allow flexion and extension of the joint.

The pain periodically changes location and most often radiates to the groin area and lower extremities. Sometimes the sensations are associated with spinal disease and confused with osteochondrosis.

Another characteristic sign of the second degree of osteoporosis is the appearance of creaking and crunching when moving, which is accompanied by painful shooting pains.

The affected limb is shortened due to dystrophic changes in the pelvic muscles.

The disease can be diagnosed using x-rays. The pictures already clearly show the growth of calcium deposits and the beginning of deformation of the head of the femoral joint. The gap in the joint increases three times, and the head rises.

3rd degree

The advanced stage of osteoporosis leads to complete occlusion of the joint.

The muscles surrounding the hip joint are atrophied, and the soft tissues are partially affected by necrosis. The pain intensifies and does not go away around the clock.

The pelvic bones are deformed, and the tilt towards the lesion is increased, which is already noticeable to the naked eye.

On an x-ray, the joint space is either not visible at all, or a slight shadow is visible. The entire cavity is filled with osteophytes.

The femoral neck is thickened and its edges are indistinguishable.

At this stage of the disease, conservative methods are practically powerless. The only way to restore mobility to your legs is through surgery and complex therapy.

Methods and methods for treating osteoporosis in the hip joint

The main direction of treatment for osteoporosis is to inhibit the process of joint destruction, replenish the lack of calcium and other microelements important for bone growth, as well as activate the processes of natural bone regeneration.

There are many treatment methods; at different stages they are combined and the optimal regimen is selected for the individual case.

The main areas include:

• Drug treatment;
• Physiotherapy, massage;
• Plasmolifting;
• Gymnastics and therapeutic exercises using various methods;
• Alternative therapy;
• Surgical intervention.

The treatment regimen directly depends on the severity of the disease.

At the first stage, when the structure of the joint is not yet damaged and only the first signs of deformation appear, which triggers inflammation and swelling, it is enough to undergo a course of drug treatment and, if necessary, rehabilitation therapy with the help of gymnastics and physiotherapeutic procedures.

Inflammatory process and pain blocked with steroids. These can be intramuscular injections, tablets and suppositories for topical use. If the skin is not damaged, ointments with an anti-inflammatory effect are used. In case of exacerbation, antibacterial therapy is used. To prevent thrombosis in immobilized limbs, blood thinning drugs are used.

Muscle tone in osteoporosis is due to compensation due to the unstable condition of the joint. This leads to problems with blood flow in the damaged area. Antispasmodic drugs like No-shpa and Drotaverine can prevent this. Drugs to reduce permeability can help blood circulation.