The Management of Common Metabolic Bone Disorders by Gordon Campbell

By Gordon Campbell

This concise useful advisor introduces the research, prognosis, and therapy of universal metabolic bone ailments and issues of calcium metabolism. all the most typical such illnesses are lined, together with osteoporosis, osteomalacia, malignant bone sickness, Paget's disorder, and hyper- and hypocalcaemia. the amount concludes with a short examine a few of the rarer stipulations that will be encountered. The ebook summarizes in short the latest advances within the realizing of the etiology of those ailments and gives worthwhile assistance on remedy regimes. This quantity might be a useful advisor for the numerous basic physicians, rheumatologists, geriatrics experts, and endocrinologists who stumble upon sufferers with bone issues.

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Measurements at this site reflect both cortical and trabecular bone mass, values obtained for the distal forearm predominantly reflecting trabecular bone mass and those at more proximal sites cortical bone mass. The technique is based on transmission measurements through tissues of a monoenergenetic energy source, usually '"iodine, differential photon absorption between bone and soft tissue enabling calculation of bone mineral content, usually expressed as a ratio to bone width in grams/cm2. Investigation of metabolic bone disease 21 The use of a dual energy photon source enables simultaneous transmission measurements through bone and soft tissue; the technique can thus be applied to the axial skeleton, but has now been superseded by dual energy X-ray absorptiometry.

Whereas the major target of prophylactic measures is to prevent fracture, the aim of treatment in patients with established disease is both to reduce the risk of further fracture and to alleviate existing symptoms. The pain associated with vertebral fractures is often underestimated and its treatment correspondingly inadequate; appropriate analgesic therapy in the early stages not only provides symptomatic relief but also ensures that immobility following the fracture, which may further compromise bone mass, is reduced to a minimum.

In women with a menopause before the age of 40 years, hormone replacement therapy should be given routinely, and bone densitometry is not generally required, although the demonstration of low bone mass may be useful in persuading those who are reluctant to take hormone replacement therapy; conversely, women in whom relative contraindications to such therapy exist may be reassured by the finding of normal bone mass, although in high risk cases bone densitometry should be repeated at intervals of one to two years.

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