Differentiate between Osteoporosis and Osteomalacia.

OSTEOPOROSIS:

1. It is a progressive bone disease that is characterized by decrease in bone mass and density which leads to increase risk of fracture.
2. It can be classified into a) Postmenopausal (type-1) osteoporosis b)Senile (type-2) osteoporosis.
3. Weakened bones that are no longer able to support body weight can break even on slight pressure. Most common fracture occur in spine, wrist and hip bones.
4. Bone density measurement by a method called DEXA (Dual Energy X-ray Absorptiometry) is the most effective way to assess osteoporosis risk.
5. Hormone replacement therapy (HRT) consisting estrogen alone or progesterone and estrogen has been found useful in reducing menopausal vasomotor symptoms.
6. Postmenopausal osteoporosis occur after menopause is related to decrease in gonadal steroids.
7. Ageing patients are to be maintained at optimum state of health (important to evaluate exposure to sunlight and vitamin-D intake and recommend vitamin-D prophylaxis to patients at risk. 

OSTEOMALACIA:

1. It is the softening of bones caused by impaired bone metabolism primarily due to inadequate levels of calcium and vitamin-D.
2. It is classified as Vitamin-D responsive or vitamin-D resistant.
3. Bone pain especially in hips is very common symptom. Dull aching pain can spread from hips to lower back, pelvis, legs and even ribs.
4. Blood test to check low levels of vitamin D, calcium, phosphorus in blood can help diagnose osteomalacia. A bone biopsy may be required to definitively diagnose osteomalacia.
5. Treatment can be simply as taking oral supplements for vitamin D, calcium and phosphorus.
6. No such role of gonadal steroids is involved.
7. Several unusual forms of vitamin D resistant rickets have been described which involves end organ hyposensitivity (pseudo vitamin-D deficiency) to biologically active vitamin-D.