Progressive Spinal Deformity in Osteoporosis


WORKUP IN SYMPTOMATIC DISEASE


Causes of symptomatic bone loss must be systematically excluded. The patient’s history may suggest bone loss secondary to hyperthyroidism, primary hyperparathyroidism, chronic glucocorticoid excess (hyperadrenalism or hypercorticism), myeloma, or osteomalacia. Therefore, a thorough history is essential in making the differential diagnosis and should include the following:


1. History of Acute Illness. Onset and duration of symptoms; location and radiation of pain; exacerbating and remitting factors; relationship of pain to posture, activity, time of day


2. Review of Related Symptoms. Malaise; recent weight loss or weight gain; loss of height; hot flashes; changes in visual fields; purpura or acne; amenorrhea; hypertension; goiter or neck swelling; change in voice, skin texture, or hair consistency; sensitivity to temperature change; palpitations; epigastric pain or burning, change in bowel habits, diarrhea, loose or bulky foul-smelling stools; dysuria, flank pain, fever, renal colic, nephrolithiasis; joint pain or swelling; generalized bone pain or muscle weakness; psychiatric problems


3. Medical and Personal History. Menstrual history, pregnancy, lactation, oophorectomy; thyroidectomy; pituitary surgery; ulcer or bowel surgery; surgery for cancer, spinal disorders (e.g., scoliosis), or bone or joint fractures



Medications: Anticonvulsants; tranquilizers; antimetabolites; vitamins and minerals; nutritional supplements; contraceptives; thyroid hormone replacement; glucocorticoids


Dietary history: Daily intake of dairy products, protein, alcohol; any discomfort with ingestion of dairy products; abuse of laxatives


Activity level: Daily weight-bearing activity; work history (physical or sedentary); exercise; sports; activity limitations; prolonged immobilization; exposure to sunlight

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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Progressive Spinal Deformity in Osteoporosis
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