الكورتيزون هو دواء محوري ف حالات طبيه كثيره في شتي تخصصات الطب 

وفهم كيفيه تاثيره علي جوده وكثافه العظام امر ضروري جدا 

في هذه الحاله يشتكي المريض من مرض جيني يسبب له التهابات واوجاع مستمره في عضلاته 

Polymyalgia Rheumatica 

ونتيجه لذلك تم وصف كورس من الكورتيزون له عل مدار سنه كامله 

بعدها لوحظ تاثر كثافه لاعظام بالعلاج عن طريق اجراء ديكسا سكان الشهير

وفي الفيديو اشرح ال 

Pathophysiolog

لكيفيه تاثير الكورتيزون علي خلايا العظام البناءه والهدامه 

Prednisone is a type of glucocorticoid medication that is often used to treat various inflammatory conditions. 

However, chronic use of prednisone is associated with an appreciable risk of bone loss, a condition known as glucocorticoid-induced osteoporosis.

Here's how it works:

1. **Increased Bone Resorption**: Glucocorticoids like prednisone stimulate osteoclast proliferation, which leads to increased bone resorption.

 This is achieved by suppressing the synthesis of osteoprotegerin, an inhibitor of osteoclast differentiation, 

and by stimulating the production of the receptor activator of nuclear factor kappa-B (RANK), which is required for osteoclastogenesis.

2. **Reduced Bone Formation**: Glucocorticoids also reduce bone formation. 

They accelerate bone resorption while inhibiting bone formation, leading to early rapid bone loss

. With chronic use, osteoclast-mediated bone resorption slows, and suppression of bone formation becomes the predominant skeletal effect.

3. **Hormonal Effects**: Glucocorticoids increase bone resorption by decreasing secretion of androgens and estrogens, 

mediated primarily by inhibition of gonadotropin secretion.

The risk of bone loss is most pronounced in the first few months of use,

 followed by slower but steady loss of bone with continued use. 

Even low doses of prednisone (as low as 2.5 to 7.5 mg daily) have been reported to increase the risk of fracture.

Therefore, it's important to treat glucocorticoid-induced bone loss aggressively, particularly in those already at high risk for fracture (older age, prior fragility fracture)⊃1;. The dose and duration of glucocorticoid therapy should be as low as possible, and alternative therapy should be used whenever possible⊃1;.