Diagnosis and Clinical Aspects of Osteoporosis

  • John A. KanisEmail author


Osteoporosis is a systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. The diagnosis is made from the measurement of bone mineral density (BMD). However, factors other than BMD contribute to fracture risk so that a distinction is made between the diagnosis of osteoporosis and the assessment of fracture risk. Major osteoporotic fractures comprise those at the hip, distal forearm, spine and proximal humerus. Of these, hip fractures incur the greatest burden in terms of cost, chrinic morbidity and mortality.


Osteoporosis Bone mineral density Fragility fracture Osteopenia Hip fracture Vertebral fracture Forearm fracture Disease burden 


  1. 1.
    Anonymous. Consensus Development Conference. Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med. 1993;94:646–50.CrossRefGoogle Scholar
  2. 2.
    Kanis JA, McCloskey EV, Johansson H, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013;24:23–57.CrossRefGoogle Scholar
  3. 3.
    [No authors listed]. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. World Health Organ Tech Rep Ser. 1994;843:1–129.Google Scholar
  4. 4.
    Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N. A reference standard for the description of osteoporosis. Bone. 2008;42:467–75.CrossRefGoogle Scholar
  5. 5.
    Looker AC, Wahner HW, Dunn WL, et al. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8:468–86.CrossRefGoogle Scholar
  6. 6.
    Sanders KM, Pasco JA, Ugoni AM, et al. The exclusion of high trauma fractures may underestimate the prevalence of bone fragility fractures in the community: the Geelong Osteoporosis Study. J Bone Miner Res. 1998;13:1337–42.CrossRefGoogle Scholar
  7. 7.
    Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001;12:417–27.CrossRefGoogle Scholar
  8. 8.
    Kanis JA on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK, 2008. Accessed 5 Jan 2016.
  9. 9.
    Poór G, Atkinson EJ, O'Fallon WM, Melton LJ 3rd. Determinants of reduced survival following hip fractures in men. Clin Orthop Rel Res. 1995;319:260–5.Google Scholar
  10. 10.
    Melton LJ 3rd. Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res. 2003;18:1139–41.CrossRefGoogle Scholar
  11. 11.
    Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl D, Cooper C, IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23:2239–56.CrossRefGoogle Scholar
  12. 12.
    Kanis JA, Johnell O, Oden A, et al. Risk and burden of vertebral fractures in Sweden. Osteoporos Int. 2004;15:20–6.CrossRefGoogle Scholar
  13. 13.
    O’Neill TW, Cockerill W, Matthis C, et al. Back pain, disability and prevalent vertebral fracture: a prospective study. Osteoporos Int. 2004;15:760–5.CrossRefGoogle Scholar
  14. 14.
    Kaukonen JP, Karaharju EO, Porras M, Lüthje P, Jakobsson A. Functional recovery after fractures of the distal forearm: analysis of radiographic and other factors affecting the outcome. Ann Chir Gynaecol. 1988;77:27–31.PubMedGoogle Scholar
  15. 15.
    Kanis JA, Johnell O, Oden A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int. 2000;11:669–74.CrossRefGoogle Scholar
  16. 16.
    Hernlund E, Svedbom A, Ivergård M, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136.CrossRefGoogle Scholar
  17. 17.
    Svedbom A, Hernlund E, Ivergård M, et al. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. 2013;8:137.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Center for Metabolic Bone Diseases, University of Sheffield Medical SchoolSheffieldUK

Personalised recommendations