A. Epidemiology and Clinical Assessment
  • Kenneth G. Saag


  • More than 1.5 million osteoporosis-related fractures occur each year in the United States.

  • Osteoporotic fractures most often involve the femoral neck, the vertebral bodies, or the wrist. Ninety percent (90%) of all hip and spinal fractures are related to osteoporosis.

  • Among individuals now 50 years old, the lifetime risk of the any fracture in the hip, spine, or distal forearm is about 40% in Caucasion women and 13 % in Caucasian men.

  • Two types of scores are used to quantify bone mineral density (BMD): The T score is the number of standard deviations the patient’s BMD measurement is above or below the young-normal mean BMD. The Z score is the number of standard deviations the measurement is above or below the age-matched mean BMD.

  • ■ The World Health Organization (WHO) defines osteoporosis as a T score ≤ −2.5.


Bone Mineral Density Vertebral Fracture Fracture Risk Osteoporotic Fracture Quantitative Compute Tomography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    National Osteoporosis Foundation. Fast facts on osteoporosis. Available at: diseasefacts.htm. Accessed July 2, 2007.
  2. 2.
    National Osteoporosis Foundation. Physician’s guide to prevention and treatment of osteoporosis. Belle Mead, NJ: Excerpta Medica; 1998.Google Scholar
  3. 3.
    Melton III LJ, Chrischilles EA. How many women have osteoporosis? J Bone Miner Res 1992;7:1005–1010.PubMedGoogle Scholar
  4. 4.
    Chrischilles EA, et al. A model of lifetime osteoporosis impact. Arch Intern Med 1991;151: 2026–2032.PubMedCrossRefGoogle Scholar
  5. 5.
    Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 1989;149:2445–2448.PubMedCrossRefGoogle Scholar
  6. 6.
    National Osteoporosis Foundation. Osteoporosis: review of the evidence for prevention, diagnosis, and treatment and cost-effectiveness analysis. Status report. Osteoporos Int 1998;8(Suppl 4):S1–S88.Google Scholar
  7. 7.
    Popovic JR. 1999 National Hospital Discharge Survey: annual summary with detailed diagnosis and procedure data. Vital Health Stat 2001;13:i-v, 1–206.Google Scholar
  8. 8.
    Cooper C, Campion G, Melton LJ III. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2: 285–289.PubMedCrossRefGoogle Scholar
  9. 9.
    Farmer ME, et al. Race and sex differences in hip fracture incidence. Am J Public Health 1984;74:1374–1830.PubMedCrossRefGoogle Scholar
  10. 10.
    Sugarman JR, et al. Hip fracture incidence in nursing home residents and community-dwelling older people, Washington State, 1993–1995. J Am Geriatr Soc 2002;50: 1638–1643.PubMedCrossRefGoogle Scholar
  11. 11.
    Johnell O. The socioeconomic burden of fractures: today and in the 21st century. Am J Med 1997;103:20S–25S, discussion 25S-26S.PubMedCrossRefGoogle Scholar
  12. 12.
    Ross PD. Osteoporosis: frequency, consequences, and risk factors. Arch Intern Med 1996;156:1399–1411.PubMedCrossRefGoogle Scholar
  13. 13.
    Looker AC, et al. Prevalence of low femoral bone density in older US adults from NHANES III. J Bone Miner Res 1997;12:1761–1768.PubMedCrossRefGoogle Scholar
  14. 14.
    Green AD, et al. Does this woman have osteoporosis? JAMA 2004;292:2890–2900.PubMedCrossRefGoogle Scholar
  15. 15.
    Genant HK, et al. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993;8: 1137–1148.PubMedCrossRefGoogle Scholar
  16. 16.
    Watts NB. Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporos Int 2004;15:847–854.PubMedCrossRefGoogle Scholar
  17. 17.
    Nelson HD, et al. Osteoporosis and fractures in postmenopausal women using estrogen. Arch Intern Med 2002;162:2278–2284.PubMedCrossRefGoogle Scholar
  18. 18.
    International Society for Clinical Densitometry (ISCD). Official positions of the ISCD. J Clin Densitom 2002; 5(Suppl).Google Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Kenneth G. Saag
    • 1
  1. 1.Center for Education and Research on Therapeutics of Musculoskeletal Disorders, Division of Clinical Immunology and RheumatologyUniversity of Alabama at BirminghamBirminghamUSA

Personalised recommendations