The incidence of osteoporosis worldwide and in the Russian Federation in particular is quite high. According to modern medicine, up to 34% of women and up to 27% of men aged 50 years and older have some signs of osteoporosis. Next, we will consider in more detail what kind of pathology it is and how to stop its negative impact on the musculoskeletal system.
Osteoporosis has the following characteristics:
This is what healthy bone looks like:
And this is what bone tissue looks like in a patient with osteoporosis:
Considering the above features of the disease, you should remember:
Next, we consider the main risk factors for osteoporosis in older people, the influence of which has been sufficiently studied in medicine. Among them, one can single out those that can be influenced by a person, if he wants it, and those that cannot be influenced.
You can reduce the impact of the following risk factors:
But the factors below, unfortunately, are not amenable to influence:
Osteoporosis can act as an independent disease (after 40 years, more often in women, primary), or it can be a syndrome that develops in the presence of certain pathologies, regardless of age (also called secondary). In the classification (ICD 10), osteoporosis has a code from M80 to M82 (with a fracture, without a fracture, and with other pathologies).
The main pathologies that are the causes of osteoporosis (secondary form) are shown in the table below.
| Primary | Secondary | |
| Postmenopausal osteoporosis (type I) | Endogenous hypercortisolism (Itsenko-Cushing's disease or syndrome). Hypogonadism. Hyperparathyroidism | Rheumatoid arthritis. Systemic lupus erythematosus. Ankylosing spondylitis |
| Senile osteoporosis(II type) | thyrotoxicosis. Diabetes mellitus (insulin dependent). Hypopituitarism, polyglandular endocrine insufficiency | Condition after resection of the stomach. Malabsorption. Chronic liver diseases |
| Juvenile osteoporosis | Myeloma. Thalassemia. Systemic mastocytosis. Leukemias and lymphomas | Chronic renal failure. Renal tubular acidosis. Fanconi syndrome |
| Idiopathic osteoporosis | Immobilization. Ovariectomy. Chronic obstructive pulmonary disease. Alcoholism. Anorexia nervosa. Eating disorders. Organ transplant | Imperfect osteogenesis. Marfan syndrome. Ehlers-Danlos syndrome (imperfect desmogenesis). Homocystinuria and lysinuria |
| Corticosteroids. Anticonvulsants. Immunosuppressants. Gonadotropin-releasing hormone agonists. Antacids containing aluminum. Thyroid hormones | ||
The main causes of the primary form of the disease are shown in the table below.
Next, consider how osteochondrosis manifests itself. We emphasize once again that in the classical manifestation it has no symptoms, the first complaints in a person arise with the development of complications. What are these complications?
As a rule, these are pathological fractures with characteristic complaints:
These fractures are called pathological because the minimal impact of physical factors (a slight fall, a slight lifting of gravity, a slight blow) can provoke a violation of the integrity of the bone. The strength of such an impact under normal conditions (in a healthy person) will not cause such consequences. The most favorite localization of fractures:
Other localizations of fractures (for example, ribs) are associated by the authors to a greater extent with the development of a secondary form.
As a rule, the identification of osteoporosis contribute to:
Which doctor should be contacted for the initial diagnosis of the disease? First of all, this disease can be diagnosed by a general practitioner, after the diagnosis is established, the patient can remain under his supervision or be transferred to a rheumatologist. In practice, neurologists, chiropractors and osteopaths often encounter pathology, which is associated with the peculiarities of the localization of compression fractures.
The first signs of osteoporosis are detected only when using laboratory and instrumental diagnostic methods.
The main methods for diagnosing osteoporosis are:
Effective treatment of osteoporosis involves a combination of drug and supportive therapies. Of the drugs used are the following:
In addition to one of the drugs prescribed by the attending physician, adequate doses of calcium (1000-1500 mg per day, including food) and vitamin D (800-2000 IU per day) are added. Treatment of osteoporosis is carried out for a long time, taking drugs, as a rule, requires 3-5 years with mandatory medical supervision once every 1-3 months according to the patient's well-being. The table below shows the main drugs for the treatment of the disease, as well as their dosages and methods of application.
Patients often wonder if osteoporosis can be cured? Let's try to answer this question. Against the background of ongoing therapy, the attending physician determines its effectiveness, while the assessment is made on the basis of laboratory and instrumental methods of examination.
The criteria for the effectiveness of the treatment are as follows:
On the other hand, in patients with pain in osteoporosis (and hence a violation of the integrity of the bone tissue), as well as other symptoms associated with the development of complications, despite the therapy and its effectiveness, complaints can persist for a long time. Indeed, the likelihood of relief from back pain due to a compression fracture, even if bone density is maintained without further reduction, is minimal.
This is what osteoporosis is dangerous for, it is easier to prevent than to deal with the consequences.
Additional measures for osteoporosis of any severity are:
Possible consequences of this disease include:
Sources:
Diseases of the bone apparatus are among the most serious and difficult to treat. This is osteoporosis. It ranks fourth on the list of diseases leading to death or disability.
The insidiousness of the disease - in its latent course for a long time, the patient learns about his diagnosis, having got to the hospital after a fracture. It is completely impossible to get rid of the disease due to its chronic and recurrent nature. It is mainly diagnosed in women during menopause, however, it occurs in children and young people.
In contact with
Classmates
Osteoporosis is a severe chronic bone disease characterized by a decrease in its density. With systemic the disease affects the entire skeleton rather than individual bones. There is a decrease in bone mass and deterioration of bone quality. ICD-10 code - M80-M85.
The disease is classified as a multifactorial, since there is no causative agent of osteoporosis.
The provoking factors of the disease are:
Attention! In addition, the disease can be triggered by taking hormonal drugs, anticoagulants, antibiotics.
There are primary and secondary systemic osteoporosis. Primary arises due to age, poor nutrition, heredity. Secondary develops due to injuries and chronic diseases (diabetes, thyroid pathology).
It has three stages of development:
The onset is asymptomatic, with occasional fractures occurring in the second stage. Compression fractures of the vertebrae are especially dangerous. Risk factors dangerous forms of osteoporosis:
At an early stage the disease can be suspected by the following signs:
For diagnosis, laboratory and instrumental methods are used:
Urinalysis is also ordered for Dioxypyridonolin - a marker of bone destructionfabrics.
Treatment of osteoporosis is aimed at preventing fractures. This is achieved by increasing bone mass, preventing its loss.
Carefully! Hormone replacement therapy increases the risk of cancer.
To increase muscle mass, anabolic steroids are indicated. Medicines that stimulate bone formation are needed- fluorine salts, somatotropic hormone.
Symptomatic treatment is aimed at relieving pain, reducing inflammation. For this, analgesics and muscle relaxants are prescribed. To restore blood supply, physiotherapy, therapeutic massage are prescribed.
In parallel with the treatment of osteoporosis, the treatment of chronic diseases is carried out. that are provocative for it (diabetes mellitus, gastrointestinal diseases, endocrine pathologies).
Therapy of osteoporosis is impossible without nutrition correction.
A sedentary lifestyle provokes bone loss, therefore Physical activity plays an important role in the prevention of osteoporosis.. Being outdoors on a sunny day replenishes the need for vitamin D. Taking a multivitamin also makes a huge difference. for disease prevention.
Systemic osteoporosis is a dangerous chronic disease that, if left untreated, leads to disability or death. In old age, fractures grow together poorly, they can chain a person to a bed for the rest of his life. That's why it is important to start preventive measures long before the possible appearance of the first signs. Maintaining a healthy lifestyle is the main prevention.
In contact with
Osteoarthritis deformans, abbreviated as DOA, refers to chronic joint diseases. It leads to the gradual destruction of articular (hyaline) cartilage and further degenerative-dystrophic transformation of the joint itself.
ICD-10 code: M15-M19 Arthrosis. These include lesions caused by non-rheumatic diseases and predominantly affecting the peripheral joints (limbs).
Osteoarthritis of the knee joint in the international classification of diseases is called gonarthrosis and has the code M17.
In practice, there are other names for this disease, which are synonyms according to the ICD10 code: deforming arthrosis, osteoarthritis, osteoarthritis.
Osteoarthritis is considered the most common disease of the human musculoskeletal system. More than 1/5 of the world's population is affected by this disease. It is noted that women suffer from this disease much more often than men, but this difference is smoothed out with age. After the age of 70, more than 70% of the population suffers from this disease.
The most “vulnerable” joint for DOA is the hip joint. According to statistics, it accounts for 42% of cases. The second and third places were shared by the knee (34% of cases) and shoulder joints (11%). For reference: there are more than 360 joints in the human body. However, the remaining 357 account for only 13% of all diseases.
A joint is an articulation of at least two bones. Such a joint is called simple. In the knee joint, which is complex, having 2 axes of movement, three bones articulate. The joint itself is covered by the articular capsule and forms the articular cavity. It has two shells: outer and inner. Functionally, the outer shell protects the articular cavity and serves as a place for attachment of the ligaments. The inner membrane, also called synovial, produces a special fluid that serves as a kind of lubricant for rubbing bone surfaces.
A joint is formed by the articular surfaces of its constituent bones (pineal glands). These endings have hyaline (articular) cartilage on their surface, which performs a dual function: friction reduction and shock absorption. The knee joint is characterized by the presence of additional cartilage (menisci), which perform the functions of stabilizing and attenuating shock effects.
The development of arthrosis begins with damage to the tissues of the articular cartilage (ICD-10:24.1 code). The process occurs imperceptibly and is diagnosed, usually, with significant destructive changes in the articular cartilage.
Etiology
The main factors contributing to the development of arthrosis: increased physical stress on the articular cartilage, as well as the loss of functional resistance to normal stress. This leads to its pathological changes (transformation and destruction).
Factors contributing to the development of the disease determine the main prerequisites for its occurrence. So, the loss of resistance can be caused by the following circumstances:
Increased stress on articular cartilage occurs as a result of:
Articular cartilage pathogenesis
The destruction of articular cartilage is caused by prolonged microtrauma of the articulated bone surfaces or a one-stage injury. In addition, some developmental disorders, such as dysplasia, contribute to a change in the geometry of articulating bone surfaces and their compatibility. As a result, the articular cartilage loses its elasticity and integrity and ceases to perform its functions of cushioning and reducing friction.
This leads to the fact that strands begin to form from the connective tissue, designed to compensate for changes in the kinematics of the joint. The consequence is an increase in the amount of synovial fluid in the joint cavity, which also changes its composition. The thinning and destruction of the articular cartilage leads to the fact that the bone endings begin to grow under the influence of loads in order to distribute them more evenly. Osteo-cartilaginous osteophytes are formed (ICD-10 code: M25.7 Osteophyte). Further changes concern the surrounding muscle tissue, which atrophies and leads to a deterioration in blood circulation and an increase in pathological changes in the joints.
The main symptoms of DOA include:
Pain
Joint pain is the main reason for a visit to a specialist. Initially, it manifests itself irregularly, mainly during movement (running, walking), hypothermia, or prolonged uncomfortable body position. Then the pain acquires a non-disappearing character and its intensity increases.
Difficulty in movement
At an early stage, gonarthrosis is characterized by a feeling of "stiffness" that appears after a long rest (sleep, rest). The knee joint becomes less mobile, its sensitivity decreases and pains of varying intensity are felt. All these manifestations decrease or completely disappear during movement.
Another characteristic symptom is creaking, clicking and other extraneous sounds that occur during long walking or a sudden change in body position. In the future, these sounds become a constant accompaniment during movement.
dangling joint
Often, arthrosis of the knee joint leads to its pathologically hypertrophied mobility. According to the ICD code 10: M25.2, this is defined as a "dangling joint". This is manifested in a linear or horizontal mobility unusual for him. A decrease in the sensitivity of the terminal sections of the limbs was noted.
The main functions of the knee joint are to move (motor function) and maintain body position (support function). Arthrosis leads to functional disorders. This can be expressed both in the limited amplitude of its movement, and in excessive mobility, “looseness” of the joint. The latter is a consequence of damage to the capsular-ligamentous apparatus or hypertrophied muscle development.
With the development of the disease, the motor function of the diarthrotic joint degrades, passive contractures begin to appear, characterized by limited passive movements in the joint (ICD code 10: M25.6 Stiffness in the joint).
Musculoskeletal dysfunction
The ongoing degenerative-dystrophic changes develop over time into dysfunction (motor and support) of the entire lower limb. This is manifested in lameness and stiffness of movements, unstable work of the musculoskeletal system. Irreversible processes of deformation of the limb begin, which ultimately leads to disability and disability.
Other symptoms
These non-primary symptoms include:
The problem of diagnosing arthrosis is that the appearance of the main symptoms with which the patient comes to the specialist already indicate certain serious changes in the joint. In some cases, these changes are pathological.
Preliminary diagnosis is made on the basis of a detailed medical history of the patient, taking into account his age, gender, profession, lifestyle, injuries and heredity.
A visual examination allows you to see those characteristic symptoms of arthrosis that were discussed: swelling, increased local skin temperature. Palpation allows you to determine the pain, the presence of excess joint fluid. It seems possible to determine the amplitude of movement of the affected area, to understand the degree of limitation of motor function. In some cases, characteristic deformities of the limbs are noticeable. This happens with a long course of the disease.
Instrumental examination methods
The main methods of instrumental diagnosis of DOA include:
In 90% of cases, an x-ray is enough to diagnose arthrosis. In cases that are difficult or unclear for diagnosing, other methods of instrumental diagnostics are in demand.
The main signs that allow diagnosing DOA by X-ray:
In some cases, radiography reveals a number of additional signs of arthrosis: articular cysts, joint erosion, dislocations.
Osteoporosis is a syndrome that is characteristic of many diseases, characterized by a generalized loss of bone tissue volume that exceeds age and gender norms and leads to a decrease in bone strength, which leads to susceptibility to fractures (spontaneous or with minimal trauma).
It should be distinguished from osteopenia (age-related atrophy of bone tissue) and osteomalacia (impaired mineralization of the bone matrix).
Classification of diseases exists to simplify the work of doctors. It contains causes, signs and diagnoses.
In the ICD of Diseases of the 10th revision, there is information about the development of a degenerative disease, how differential diagnosis is carried out. There is also information that describes patient education and clinical recommendations, the correct behavior during bone resorption.
Osteoporosis according to ICD 10 is a degenerative condition in which there is a decrease in bone mass and bone density. They become porous and brittle.
The destruction of the bones accompanies the pain syndrome, which increases as it progresses.
A decrease in bone density occurs for various reasons. Doctors distinguish primary and secondary type.
After the introduction of a protocol that divides the disease into certain categories, it became more convenient for doctors to diagnose and prescribe treatment. As part of this protocol, doctors also stimulate patients and encourage them to maintain a proper lifestyle to prevent the development of pathology, to prevent a decrease in bone mineral density.
Conditions with a pathological fracture M80 includes nine sub-items. Osteoporosis m81 is the type without pathological fracture, but there is bone loss in the joints.
The primary disease is osteoporosis, ICD code 10:
Primary osteoporosis is also senile and juvenile. Secondary osteoporosis is formed due to other conditions. Codes according to ICD 10 (the first code is with pathological, the second is without it):
Osteoporosis is a medical problem of an international nature that the entire scientific community and practitioners of various specialties and directions have to face. According to ICD 10, osteoporosis is identified in the XIII subclass "Diseases of the musculoskeletal system and connective tissue."
Code according to the international classification of diseases of the 10th revision (ICD 10):
Physical exercises with a predominance of static loads and isometric contractions of the back muscles (for example, swimming) Falls should be avoided.
Moderate restriction of dietary intake of protein and phosphorus (meat, fish, legumes should not be abused), as well as alcoholic beverages Inhibition of bone resorption and stimulation of its formation Ensuring sufficient intake of calcium from food or inhibition of its excretion.
With moderate postmenopausal
osteoporosis
Ensuring the intake of 1-1.5 g / day of calcium (in the absence of hypercalciuria and calcium stones), for example, in the form of calcium carbonate 600 mg 4-6 r / day, and ergocalciferol 400 IU / day. Continuous hormone replacement therapy (estradiol dienogest).
With severe or progressive postmenopausal
As can be seen, all age categories are subject to the risk factor.
Preventive actions will help to avoid or reduce the risk of disease. From early childhood and adolescence, a healthy skeletal system requires an adequate supply of minerals. The supply of calcium in the bone system will help maintain immunity in the future. Moderate alcohol consumption and smoking cessation increase the safety of calcium excretion from the body.
Take care of yourself and be always healthy!
Be sure to consult your doctor before treating diseases. This will help to take into account individual tolerance, confirm the diagnosis, make sure the treatment is correct and exclude negative drug interactions.
If you use prescriptions without consulting a doctor, then this is entirely at your own risk. All information on the site is presented for informational purposes and is not a medical aid.
You are solely responsible for the application.
The International Classification of Diseases of the 10th revision is a single register in which codes are indicated. After the introduction of the protocol, it became easier for doctors to track degenerative conditions. Osteoporosis with and without a pathological fracture caused by various conditions is also included in the international classification of diseases. It is characterized by damage to the bone structure, a decrease in bone mineral density, a low calcium content, and is accompanied by vertebral fractures. With this disease, bone destruction occurs in the bone structure. Osteoporosis ICD 10 occupies sections M80, M81, M82.
Classification of diseases exists to simplify the work of doctors. It contains causes, signs and diagnoses. In the ICD of Diseases of the 10th revision, there is information about the development of a degenerative disease, how differential diagnosis is carried out. There is also information that describes patient education and clinical recommendations, the correct behavior during bone resorption. Osteoporosis according to ICD 10 is a degenerative condition in which there is a decrease in bone mass and bone density. They become porous and brittle. The destruction of the bones accompanies the pain syndrome, which increases as it progresses.
In diseases classified in the ICD, degenerative pathology is introduced into subclass 8. Osteoporosis ICD 10 - codes:
Due to a decrease in bone mineral density, the likelihood of a violation of the integrity of the skeleton increases. Pathogenetic treatment includes the appointment of drugs that relieve pain, serving as a prophylaxis of the disease to prevent the formation of new bone fractures. Patient education, clinical recommendations given by doctors allow the formation of new bone tissue. Ailments caused by various conditions respond well to treatment in the early stages. The processes of synthesizing and destroying a large amount of bone tissue are accompanied by fractures of the vertebrae and other skeletal structures.
A decrease in bone density occurs for various reasons. Doctors distinguish primary and secondary type. After the introduction of a protocol that divides the disease into certain categories, it became more convenient for doctors to diagnose and prescribe treatment. As part of this protocol, doctors also stimulate patients and encourage them to maintain a proper lifestyle to prevent the development of pathology, to prevent a decrease in bone mineral density. Conditions with a pathological fracture M80 includes nine sub-items. Osteoporosis m81 is the type without pathological fracture, but there is bone loss in the joints.
The primary disease is osteoporosis, ICD code 10:
Primary osteoporosis is also senile and juvenile. Secondary osteoporosis is formed due to other conditions. Codes according to ICD 10 (the first code is with pathological, the second is without it):
Pathogenetic treatment includes the appointment of drugs according to the type of disease. If the calcium content is low, but there is no fracture, the patient is prescribed Actonel, Ideos, Calcium Dz Nycomed, Alfadol-Sa. In the presence of a violation of the integrity of the skeleton, to restore the volume of bone tissue, patients are prescribed Natekal Dz, Aklasta, Ideos. If the disease is caused by endocrine disorders, the use of the drug "Osteogenon" is prescribed. In ICD 10, under each subparagraph, drugs are indicated that are used for a certain type of degenerative-dystrophic pathology. This makes it easier for doctors to work.
Share article: Post navigation
