Abstract
Osteoporosis is a systemic disease characterized by decreased bone strength and an increased risk of fracture. Bone strength progressively declines with aging, and therefore osteoporosis is considered an inevitable process and is not approached as a relevant clinical problem. However, several intervening factors may accelerate this involutional process. One of the major reasons is that osteoporosis is asymptomatic until a fracture occurs, and therefore both the physician and the patients fail to appreciate its importance. As a matter of fact, many patients with osteoporosis and/or at increased risk of fracture are still underdiagnosed and undertreated.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bonjour JP, Chevalley T. Pubertal timing, bone acquisition, and risk of fracture throughout life. Endocr Rev. 2014;35(5):820–47. https://doi.org/10.1210/er.2014-1007.
Gaddini GW, Turner RT, Grant KA, Iwaniec UT. Alcohol: a simple nutrient with complex actions on bone in the adult skeleton. Alcohol Clin Exp Res. 2016;40(4):657–71. https://doi.org/10.1111/acer.13000.
Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA, Pols H, Tenenhouse A. Alcohol intake as a risk factor for fracture. Osteoporos Int. 2005;16(7):737–42. https://doi.org/10.1007/s00198-004-1734-y.
Bijelic R, Milicevic S, Balaban J. Risk factors for osteoporosis in postmenopausal women. Med Arch. 2017;71(1):25–8. https://doi.org/10.5455/medarh.2017.71.25-28.
Brook JS, Balka EB, Zhang C. The smoking patterns of women in their forties: their relationship to later osteoporosis. Psychol Rep. 2012;110(2):351–62. https://doi.org/10.2466/13.18.PR0.110.2.351-362.
Pietschmann F, Breslau NA, Pak CY. Reduced vertebral bone density in hypercalciuric nephrolithiasis. J Bone Miner Res. 1992;7(12):1383–8. https://doi.org/10.1002/jbmr.5650071205.
Kaunitz AM, Arias R, McClung M. Bone density recovery after depot medroxyprogesterone acetate injectable contraception use. Contraception. 2008;77(2):67–76. https://doi.org/10.1016/j.contraception.2007.10.005.
Thornton D, Gordon CM. Restrictive eating disorders and skeletal health in adolescent girls and young women. Calcif Tissue Int. 2017;100(5):449–60. https://doi.org/10.1007/s00223-016-0164-0.
Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ, Harris ST, Jan de Beur SM, Khosla S, Lane NE, Lindsay R, Nana AD, Orwoll ES, Saag K, Silverman S, Watts NB. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014;25(5):1439–43. https://doi.org/10.1007/s00198-014-2655-z.
Melton LJ, Atkinson EJ, Cooper C, O'Fallon WM, Riggs BL. Vertebral fractures predict subsequent fractures. Osteoporos Int. 1999;10(3):214–21.
Mackey DC, Lui LY, Cawthon PM, Bauer DC, Nevitt MC, Cauley JA, Hillier TA, Lewis CE, Barrett-Connor E, Cummings SR, Study of Osteoporotic F, Osteoporotic Fractures in Men Study Research G. High-trauma fractures and low bone mineral density in older women and men. JAMA. 2007;298(20):2381–8. https://doi.org/10.1001/jama.298.20.2381.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146. https://doi.org/10.1002/14651858.CD007146.pub3.
Smulders E, Weerdesteyn V, Groen BE, Duysens J, Eijsbouts A, Laan R, van Lankveld W. Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial. Arch Phys Med Rehabil. 2010;91(11):1705–11. https://doi.org/10.1016/j.apmr.2010.08.004.
Compston J. Clinical question: what is the best approach to managing glucocorticoid-induced osteoporosis? Clin Endocrinol. 2011;74(5):547–50. https://doi.org/10.1111/j.1365-2265.2011.03994.x.
Paggiosi MA, Peel NF, Eastell R. The impact of glucocorticoid therapy on trabecular bone score in older women. Osteoporos Int. 2015;26(6):1773–80. https://doi.org/10.1007/s00198-015-3078-1.
Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis. 2014;6(5):185–202. https://doi.org/10.1177/1759720X14546350.
Tufano A, Coppola A, Contaldi P, Franchini M, Minno GD. Oral anticoagulant drugs and the risk of osteoporosis: new anticoagulants better than old? Semin Thromb Hemost. 2015;41(4):382–8. https://doi.org/10.1055/s-0034-1543999.
Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int. 2007;18(4):427–44. https://doi.org/10.1007/s00198-006-0253-4.
Yamagishi S, Maeda S, Matsui T, Ueda S, Fukami K, Okuda S. Role of advanced glycation end products (AGEs) and oxidative stress in vascular complications in diabetes. Biochim Biophys Acta. 2012;1820(5):663–71. https://doi.org/10.1016/j.bbagen.2011.03.014.
Kanis JA, Hans D, Cooper C, Baim S, Bilezikian JP, Binkley N, Cauley JA, Compston JE, Dawson-Hughes B, El-Hajj Fuleihan G, Johansson H, Leslie WD, Lewiecki EM, Luckey M, Oden A, Papapoulos SE, Poiana C, Rizzoli R, Wahl DA, McCloskey EV, Task Force of the FI. Interpretation and use of FRAX in clinical practice. Osteoporos Int. 2011;22(9):2395–411. https://doi.org/10.1007/s00198-011-1713-z.
Compston J. Osteoporosis: advances in risk assessment and management. Clin Med. 2016;16(Suppl 6):s121–4. https://doi.org/10.7861/clinmedicine.16-6-s121.
Adami S, Bianchi G, Brandi ML, Di Munno O, Frediani B, Gatti D, Giannini S, Girasole G, Minisola G, Minisola S, Nuti R, Pedrazzoni M, Rossini M, Varenna M. Validation and further development of the WHO 10-year fracture risk assessment tool in Italian postmenopausal women: project rationale and description. Clin Exp Rheumatol. 2010;28(4):561–70.
Naylor K, Eastell R. Bone turnover markers: use in osteoporosis. Nat Rev Rheumatol. 2012;8(7):379–89. https://doi.org/10.1038/nrrheum.2012.86.
Garnero P, Shih WJ, Gineyts E, Karpf DB, Delmas PD. Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment. J Clin Endocrinol Metab. 1994;79(6):1693–700. https://doi.org/10.1210/jcem.79.6.7989477.
Diez-Perez A, Naylor KE, Abrahamsen B, Agnusdei D, Brandi ML, Cooper C, Dennison E, Eriksen EF, Gold DT, Guanabens N, Hadji P, Hiligsmann M, Horne R, Josse R, Kanis JA, Obermayer-Pietsch B, Prieto-Alhambra D, Reginster JY, Rizzoli R, Silverman S, Zillikens MC, Eastell R, Adherence Working Group of the International Osteoporosis F, the European Calcified Tissue S. International Osteoporosis Foundation and European Calcified Tissue Society Working Group. Recommendations for the screening of adherence to oral bisphosphonates. Osteoporos Int. 2017;28(3):767–74. https://doi.org/10.1007/s00198-017-3906-6.
Lewiecki EM, Laster AJ. Clinical review: clinical applications of vertebral fracture assessment by dual-energy X-ray absorptiometry. J Clin Endocrinol Metab. 2006;91(11):4215–22. https://doi.org/10.1210/jc.2006-1178.
Jiang G, Eastell R, Barrington NA, Ferrar L. Comparison of methods for the visual identification of prevalent vertebral fracture in osteoporosis. Osteoporos Int. 2004;15(11):887–96. https://doi.org/10.1007/s00198-004-1626-1.
Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993;8(9):1137–48. https://doi.org/10.1002/jbmr.5650080915.
Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ. Classification of vertebral fractures. J Bone Miner Res. 1991;6(3):207–15. https://doi.org/10.1002/jbmr.5650060302.
McCloskey EV, Spector TD, Eyres KS, Fern ED, O'Rourke N, Vasikaran S, Kanis JA. The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporos Int. 1993;3(3):138–47.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Marcocci, C., Saponaro, F. (2018). Osteoporosis Diagnosis. In: Lenzi, A., Migliaccio, S. (eds) Multidisciplinary Approach to Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-75110-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-75110-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75108-5
Online ISBN: 978-3-319-75110-8
eBook Packages: MedicineMedicine (R0)