Skip to main content
SpringerLink
Log in

Osteoporosis

  • Chapter
Handbook of Diagnostic Endocrinology

Part of the book series: Contemporary Endocrinology ((COE))

  • 171 Accesses

Abstract

Osteoporosis is a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of the skeleton, leading to enhanced bone fragility and a consequent increase in fracture risk. It is the most prevalent bone disorder in industrialized countries and annually accounts for 1.5 million fractures in the U.S., incurring a total cost estimated at $13.8 billion in 1995 alone (1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ray NF, Chan JK, Thamer M, Melton LJ III. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 1997; 12: 24–35.

    Article  CAS  PubMed  Google Scholar 

  2. Melton, LJ III. How many women have osteoporosis now? J Bone Miner Res 1995; 10: 175–177.

    Article  PubMed  Google Scholar 

  3. Melton LJ III, Atkinson EJ, O’Fallon WM, Wahner HW, Riggs, BL. Long-term fracture risk prediction with bone mineral measurements made at various skeletal sites. J Bone Miner Res 1991; 6: 5136.

    Google Scholar 

  4. Miller PD, Bonnick SL, Rosen CJ. Consensus of an international panel on the clinical utility of bone mass measurements in the detection of low bone mass in the adult population. Calcif Tissue Int 1996; 58: 207–214.

    CAS  PubMed  Google Scholar 

  5. Melton LJ III, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs, BL. Prevalence and incidence of vertebral deformities. Osteoporosis Int 1993; 3: 113–119.

    Article  Google Scholar 

  6. Osteoporosis prevention, diagnosis, and therapy. NIH consensus statement online (http://consensus.nih.gov/cons/111/111statement.htm), March 27–29, 2000 (accessed 2/3/ 20021;1711:1–36.

  7. Orwoll ES, Klein RF. Osteoporosis in men. Endocr Rev 1995; 16: 87–116.

    CAS  PubMed  Google Scholar 

  8. Melton LJ III. Hip fractures: a worldwide problem today and tomorrow. Bone 1993; 14: S1 - S8.

    Article  PubMed  Google Scholar 

  9. Melton LJ III. Osteoporosis: a worldwide problem. In: Proceedings of the Third International Symposium on Osteoporosis, Washington, DC, March 2–5, 1994. Washington DC, National Osteoporosis Foundation/National Institutes of Health, p 23.

    Google Scholar 

  10. Riggs BL, Melton LJ III. Medical progress series: involutional osteoporosis. N Engl J Med 1986; 314: 1676–1686.

    Article  CAS  PubMed  Google Scholar 

  11. Doran PM, Khosla S. Senile Osteoporosis. In: Goltzman D, Henderson J, eds., Bone Primer. Cambridge University Press, New York, in press.

    Google Scholar 

  12. Riggs BL, Melton LJ III. Evidence for two distinct syndromes of involutional osteoporosis. Am J Med 1983; 75: 899–901.

    Article  CAS  PubMed  Google Scholar 

  13. Riggs BL, Melton LJ III. Clinical heterogeneity of involutional osteoporosis: implications for prevention and therapy. J Clin Endocrinol Metab 1990; 70: 1229–1232.

    Article  CAS  PubMed  Google Scholar 

  14. Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton Li III. Differential changes in bone mineral density of the appendicular skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 1981; 67: 328–335.

    Article  CAS  PubMed  Google Scholar 

  15. Epstein S, Bryce G, Hinman JW, et al. The influence of age on bone mineral regulating hormones. Bone 1986; 7: 421–425.

    Article  CAS  PubMed  Google Scholar 

  16. Kleerekoper M, Avioli LV. Evaluation and treatment of postmenopausal osteoporosis. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 3rd ed. Lippincott-Raven, Philadelphia, 1996, pp. 264–271.

    Google Scholar 

  17. Taggart HM, Tweedie DR. Spinal cord compression: remember osteoporosis. BMJ 1987; 294: 1148–1149.

    Article  CAS  PubMed  Google Scholar 

  18. Hui SL, Slemenda CW, Johnston CC Jr. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 1988; 81: 1804–1809.

    Article  CAS  PubMed  Google Scholar 

  19. Orwoll, ES. The special problem of hip fracture. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 3rd ed. Lippincott-Raven, Philadelphia, 1996, pp. 272–275.

    Google Scholar 

  20. Ross PD, Davis JW, Eptsein R, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 1991; 114: 919–923.

    CAS  PubMed  Google Scholar 

  21. Eastell R, Riggs, BL. Diagnostic evaluation of osteoporosis. Endocrinol Metab Clin North Am 1988; 17: 547–571.

    CAS  PubMed  Google Scholar 

  22. Genant HK. Radiology of osteoporosis and other metabolic bone diseases. In: Favus MJ, ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 3rd ed. Lippincott-Raven, Philadelphia, 1996, pp. 152–163.

    Google Scholar 

  23. Thomas MK, Lloyd-Jones DM, Thadani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J Med 1998; 338: 777–783.

    Article  CAS  PubMed  Google Scholar 

  24. Garnero P, Delmas PD. Biochemical markers of bone turnover: applications for osteoporosis. Endocrinol Metab Clin North Am 1998; 27: 303–323.

    Article  CAS  PubMed  Google Scholar 

  25. Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J. The use of biochemical markers of bone turnover in osteoporosis. Committee of Scientific Advisors of the International Osteoporosis Foundation. Osteoporos Int 2000; 11 (Suppl 6): 82 - S17.

    Google Scholar 

  26. Garnero P. Markers of bone turnover for the prediction of fracture risk. Osteoporos Int 2000;l 1(Suppl 6 ): S55 - S65.

    Google Scholar 

  27. Riggs BL, Melton LJ III, O’Fallon WM. Drug therapy for vertebral fractures in osteoporosis: evidence that decreases in bone turnover and increases in bone mass both determine antifracture efficacy. Bone 1996; 18: 197S - 201S.

    Article  CAS  PubMed  Google Scholar 

  28. Civitelli R, Gonnelli S, Zacchei F, Bigazzi S, Vattimo A, Avioli LV, Gennari C. Bone turnover in postmenopausal osteoporosis: effect of calcitonin treatment. J Clin Invest 1988; 82: 1268–1274.

    Article  CAS  PubMed  Google Scholar 

  29. Lufkin EG, Wahner HW, O’Fallon WM, et al. Treatment of postmenopausal osteoporosis with transdermal estrogen. Ann Intern Med 1992; 117: 109.

    Google Scholar 

  30. Garnero P, Dargent-Molina P, Hans D, et al. Do markers of bone resorption add to bone mineral density and ultrasonographic heel measurement for the prediction of hip fracture in elderly women? The EPIDOS prospective study. Osteoporos Int 1998; 8: 563–569.

    Article  CAS  PubMed  Google Scholar 

  31. Melton LJ III, Chao EYS, Lane J. Biomechanical aspects of fractures. In: Riggs BL, Melton LJ III, eds. Osteoporosis: Etiology, Diagnosis, and Management. Raven Press, New York, 1988, pp. 111–131.

    Google Scholar 

  32. Cummings SR, Black DM, Nevitt MC, et al. Bone density at various sites for prediction of hip fractures. Lancet 1993; 341: 72–75

    Article  CAS  PubMed  Google Scholar 

  33. Melton LJ III, Atkinson EJ, O’Connor MK, O’Fallon WM, Riggs, BL. Bone density and fracture risk in men. J Bone Miner Res 1998; 13: 1915–1923.

    Article  PubMed  Google Scholar 

  34. Johnell O. Prevention of fractures in the elderly: a review. Acta Orthop Scand 1995; 66: 90–98.

    Article  CAS  PubMed  Google Scholar 

  35. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994; 843: 1–129.

    Google Scholar 

  36. Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994; 9: 1137–1141.

    Article  CAS  PubMed  Google Scholar 

  37. Kanis JA, WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 1994; 4: 368–381.

    Article  Google Scholar 

  38. National Osteoporosis Foundation. Physician’s Guide to Prevention and Treatment of Osteoporosis. Excerpta Medica, Belle Mead, NJ, 1998.

    Google Scholar 

  39. Heinemann DF. Osteoporosis. An overview of the National Osteoporosis Foundation clinical practice guide. Geriatrics 2000; 55: 33–36.

    Google Scholar 

  40. Kanis JA. Diagnosis of osteoporosis. Osteoporos Int 1997; 7 (Suppl 3): 108–116.

    Article  Google Scholar 

  41. Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD. Predicting vertebral fracture incidence from prevalent fracture and the bone density among non-black, osteoporotic women. Osteoporos Int 1993; 3: 120–126.

    Article  CAS  PubMed  Google Scholar 

  42. Grampp S, Genant HK, Mathur A, et al. Comparisons of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification. J Bone Miner Res 1997; 12: 697–711.

    Article  CAS  PubMed  Google Scholar 

  43. Gluer CC, Cummings SB, Pressman A, et al. Prediction of hip fractures from pelvic radiographs: the Study of Osteoporotic Fractures. J Bone Miner Res 1994; 9: 671–677.

    Article  CAS  PubMed  Google Scholar 

  44. Blake GM, Fogelman I. Applications of bone densitometry for osteoporosis. Endocrin Metab Clin North Am 1998; 27: 267–288.

    Article  CAS  Google Scholar 

  45. Hans D, Fuerst T, Lang T, et al. How can we measure bone quality? Baillieres Clin Rheumatol 1997; 11: 495–515.

    Article  CAS  PubMed  Google Scholar 

  46. Prins SH, Jorgensen HL, Jorgensen LV, Hassager C. The role of quantitative ultrasound in the assessment of bone: a review. Clin Physiol 1998; 18: 3–17.

    Article  CAS  PubMed  Google Scholar 

  47. Genant HK, Majumdar S. High-resolution magnetic resonance imaging of trabecular bone structure. Osteoporos Int 1997; 7 (Suppl 3): S135 - S139.

    Article  PubMed  Google Scholar 

  48. Virtama P. Uneven distribution of bone mineral and covering effect of non-mineralized tissue as reasons for impaired detectability of bone density from roentgenograms. Ann Med Intern Fenn 1960; 49: 57–65.

    CAS  PubMed  Google Scholar 

  49. Smith RW Jr, Rizek J. Epidemiologic studies of osteoporosis in women of Puerto Rico and southeastern Michigan with special reference to age, race, national origin and to other related or associated findings. Clin Orthop 1966; 45: 31–48.

    PubMed  Google Scholar 

  50. Lukert M. Vertebral compression fractures: how to manage the pain, avoid disability. Geriatrics 1994; 49: 22–26.

    CAS  PubMed  Google Scholar 

  51. Black D, Cummings SR, Melton LJ III. Appendicular bone mineral and a woman’s lifetime risk of hip fracture. J Bone Miner Res 1992; 7: 639–646.

    Article  CAS  PubMed  Google Scholar 

  52. Ross PD, Wasnich RD, Heilbrun LK, Vogel JM. Definition of a spine fracture threshold based upon prospective fracture risk. Bone 1987; 8: 271–278.

    Article  CAS  PubMed  Google Scholar 

  53. Yu W, Gluer CC, Grampp S, et al. Spinal bone mineral assessment in postmenopausal women: a comparison between dual X-ray absorptiometry and quantitative computed tomography. Osteoporos Int 1995; 5: 433–439.

    Article  CAS  PubMed  Google Scholar 

  54. Blake GM, Herd RJM, Fogelman I. A longitudinal study of supine lateral DXA of the lumbar spine: a comparison with posteroanterior spine, hip and total body DXA. Osteoporos Int 1996; 6: 462–470.

    Article  CAS  PubMed  Google Scholar 

  55. Pacifici R, Rupich R, Griffin M, Chines A, Susman A, Avioli LV. Dual energy radiography versus quantitative computer tomography for the diagnosis of osteoporosis. J Clin Endocrinol Metab 1990; 70: 705–710.

    Article  CAS  PubMed  Google Scholar 

  56. Parfitt AM. Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med 1987; 82 (Suppl 1B): 68–72.

    Article  CAS  PubMed  Google Scholar 

  57. Grampp S, Jergas M, Gluer CC, Land P, Brastow P, Genant HK. Radiologic diagnosis of osteoporosis: current methods and perspectives. Radiol Clin North Am 1993; 31: 1133–1145.

    CAS  PubMed  Google Scholar 

  58. Baran DT, Faulkner KG, Genant HK, Miller PD, Pacifici R. Diagnosis and management of osteoporosis: guidelines for the utilization of bone densitometry. Calcif Tissue Int 1997; 61: 433–440.

    Article  CAS  PubMed  Google Scholar 

  59. Stewart A, Reid DM, Porter RW. Broadband ultrasound attenuation and dual energy X-ray absorptiometry in patients with hip fractures: which technique discriminates fracture risk? Calcif Tissue Int 1994; 54: 466–469.

    Article  CAS  PubMed  Google Scholar 

  60. Turner CH, Peacock M, Timmerman L, Neal JM, Johnston CC Jr. Calcaneal ultrasound measurements discriminate hip fractures independently of bone mass. Osteoporos Int 1995; 5: 130–135.

    Article  CAS  PubMed  Google Scholar 

  61. Wuster C, Paetzold W, Scheidt-Nave C, Brandt K, Ziegler R. Equivalent diagnostic validity of ultrasound and dual x-ray absorptiometry in a clinical case-comparison study of women with vertebral osteoporosis. J Bone Miner Res 1994; 9 (Suppl 1): S211.

    Google Scholar 

  62. Dargent-Molina P, Schott AM, Hans D, et al. Separate and combined value of bone mass and gait speed measurements in screening for hip fracture risk: results from the EPIDOS study. Osteoporos Int 1999; 9: 188–192.

    Article  CAS  PubMed  Google Scholar 

  63. Bauer DC, Gluer CC, Genant HK, Stone K. Quantitative ultrasound and vertebral fracture in postmenopausal women. J Bone Miner Res 1995; 10: 353–358.

    Article  CAS  PubMed  Google Scholar 

Download references

Authors
  1. Patrick M. Doran MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sundeep Khosla MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Reproductive Endocrine Unit, Division of Endocrinology, Massachusetts General Hospital, Boston, MA, USA

    Janet E. Hall MD

  2. Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Lynnette K. Nieman MD

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media New York

About this chapter

Cite this chapter

Doran, P.M., Khosla, S. (2003). Osteoporosis. In: Hall, J.E., Nieman, L.K. (eds) Handbook of Diagnostic Endocrinology. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-293-7_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-293-7_13

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-172-1

  • Online ISBN: 978-1-59259-293-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation