Prasanth surampudi
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Bone Aug 21(2):ĥ Screening for Osteoporosis in Muscular Dystrophy Progressivemyopathy, a key risk factor for reduced bonestrength Lancet Neurol Apr 17(4):Ħ Bone Basics: Osteoporosis Osteoporosis Osteoporosis has been defined by the World Health Organization as a systemic disease characterized by Diffuse Bone loss with increased fracture risk Low Bone Mineral Density (BMD) can be detected Increased osteoclast activity, decreased osteoblast activity Deterioration of bone micro architecture seen in trabecular bone, cortical bone, and or both This leads to increased Skeletal fragility à Increased fracture riskħ Bone Basics: Osteoporosis - Osteoporosis in children Osteoporosis Osteoporosis in children: Low Z score Ambulatory QUS Bone Health Data : Ambulatory vs Non Ambulatory T score distal radius T score Mid shaft tibia Ambulatory Ambulatory Non Ambulatory Non Ambulatory Ambulatory Ambulatory Non Ambulatory Non Ambulatory Z score distal radius Z score Mid shaft tibia Bone Density is worse in individuals with muscular dystrophy who become non ambulatoryġ3 Fracture Risk in DMD Fracture risk increase with Loss of Ambulation Fractures can happen in the long bones or spine and risk increases with age Fracture Probability % Mean age of loss of ambulation (11.2 yrs) Increased Fracture Probability Fracture Probability % Long Bones Vertebrae Developmental Medicine & Child Neurology 2002, 44: Journal of Child Neurology 2016, Vol. J Bone Miner Res Jan 21(1): Silva MJ, Gibson LJ Modeling the mechanical behavior of vertebral trabecular bone: effects of age-related changes in microstructure. Peak bone mass is achieved in the second or third decade, depending on the skeletal site 2 main types of Bone microarchitectures: Trabecular and Cortical Bone Trabecular bone Cortical Bone Trabecular bone is found in multiple areas including the Hip, Femoral neck, Vertebral body of spine Cortical bone is found in areas including the dense outer shafts of long bones Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, Peterson JM, Melton LJ 3 rd Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. 4 Bone Basics: Bone Structure Bone is made up of mainly collagen, calcium phosphate crystals Bone mass, can be reported as bone mineral content (BMC, (g)) or areal Bone Mineral Density (BMD (g/cm 2 )).