The Clinical Management of Osteoporosis

  • Socrates E. Papapoulos
Part of the Medical Science Symposia Series book series (MSSS, volume 13)


The clinical presentation of a patient with osteoporosis will determine the diagnostic work-up and attention should be given to excluding causes of secondary osteoporosis especially in patients with vertebral fractures. This will not be discussed further and this short review will focus on the management of the patient in whom the diagnosis primary osteoporosis has been made. The overall management consists of an integrated approach including general measures, nonpharmacological and pharmacological interventions aiming at preventing osteoporotic fractures in patients who have not fractured yet or in those who have already sustained a fragility fracture. This subject has been recently reviewed elsewhere [1,2].


Bone Mineral Density Vertebral Fracture Bone Turnover Prevalent Vertebral Fracture Antifracture Efficacy 
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.
    O’Neill T, Papapoulos S. Can we prevent fractures? Baillière’s Clin Rheumatol 1997;11:565–82.CrossRefGoogle Scholar
  2. 2.
    Papapoulos SE. Pharmacological management of osteoporosis. Aging 1998; in press.Google Scholar
  3. 3.
    Chapuy MC, Arlot ME, Delmas PD, Meunier PJ. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. Br Med J 1994;308:1081–82.Google Scholar
  4. 4.
    Chapuy MC, Arlot ME, Duboef F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Recker RR, Hinders S, Davies KM, et al. Correcting calcium nutritional deficiency prevents spine fractures in elderly women. J Bone Miner Res 1996;11:1961–66.PubMedCrossRefGoogle Scholar
  6. 6.
    Dawson-Hughes B, Harris SS, Krall EA, Dallai GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age and older. New Engl J Med 1997;337:670–76.PubMedCrossRefGoogle Scholar
  7. 7.
    Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT trials. JAMA 1995;273:1341–47.PubMedCrossRefGoogle Scholar
  8. 8.
    Lauritzen JB, Petersen MM, Luud B. Effect of external hip protectors on hip fractures. Lancet 1993;341:11–13.PubMedCrossRefGoogle Scholar
  9. 9.
    Lufkin EG, Wahner HW, O’Fallon WM, et al. Treatment of postmenopausal osteoporosis with transdermal estrogen. Ann Int Med 1992;117:1–9.PubMedGoogle Scholar
  10. 10.
    Harris ST, Watts NB, Jackson RD, et al. Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: Three years of blinded therapy followed by one year of open therapy. Am J Med 1993;95:557–67.PubMedCrossRefGoogle Scholar
  11. 11.
    Liberman UA, Weiss SR, Bröil J, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 1995;333:1437–43.PubMedCrossRefGoogle Scholar
  12. 12.
    Black DM, Cummings SR, Karpf DB, et al. Randomized trial of effect of alendronate on risk of fractures in women with existing vertebral fractures. Lancet 1996;348:1535–41.PubMedCrossRefGoogle Scholar
  13. 13.
    Karpf DB, Shapiro DR, Seeman E. Prevention of non-vertebral fractures by alendronate: A meta-analysis. JAMA 1997;227:1159–64.CrossRefGoogle Scholar
  14. 14.
    Overgaard K, Hansen MA, Jensen SB, Christiansen C. Effect of calcitonin given intranasally on bone mass and fracture rates in established osteoporosis: A dose-response study. Br Med J 1992;305:556–61.CrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers and Fondazione Giovanni Lorenzini 1999

Authors and Affiliations

  • Socrates E. Papapoulos

There are no affiliations available

Personalised recommendations