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Osteoporos

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Sakkunnig:
Definition:
En systemisk skelettsjukdom med minskad benmassa och förändringar i benvävnadens mikroarkitektur som medför skört skelett och ökad risk för frakturer.
Förekomst:
I Sverige har knappt 6 % osteoporos, varav nästan 80 % är kvinnor. Förekomsten ökar kraftigt med åldern.
Symtom:
Osteoporos ger sällan några symtom innan en fraktur inträffar och den låga bentätheten är viktig att identifiera på grund av att den är en riskfaktor för kommande frakturer.
Kliniska fynd:
Fraktur efter litet eller inget trauma är det viktigaste tecknet på osteoporos men kliniska fynd kan också vara lågt BMI, längdminskning >3 cm jämfört med maxlängd som ung eller uttalad torakal kyfos som tecken på tidigare kotfrakturer.
Diagnostik:
Beslut om benspecifik läkemedelsbehandling grundas på en samlad klinisk bedömning. Särskilt stark behandlingsindikation föreligger vid fraktur i kota eller höft.
Behandling:
Benspecifika läkemedel, eventuellt med tilläggsbehandling med kalcium och D-vitamin, men också livsstilsförändringar såsom ökad fysisk aktivitet, träning av styrka och balans samt rökstopp.
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  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet