Osteoporosis: A Danger Lurking in All Medical Disciplines

Abstract

The first step is the separation of “primary” or “idiopathic” from the “secondary” osteoporoses, which have an underlying cause, i. e., a specific disease or disorder. “Primary” osteoporosis refers mainly to postmenopausal and age-related involutional osteoporoses, in spite of the fact that a number of factors contributing to their pathogenesis are already known. “Secondary” osteoporoses comprise about 5 % of all cases of osteoporosis but are responsible for about 20 % of all osteoporotic fractures. Physicians should consider causes of secondary osteoporosis particularly among patients with:

• Unusual fractures

• Very low bone densities for their age

• Recurrent fractures despite adherence to effective therapy

• Abnormal basic laboratory tests (anaemia, hypo- and hypercalcemia, elevated ESR)

• Unexplained bone pain

• Undetermined bone lesions on bone scan or X-ray (metastases, myeloma, malignant lymphomas, mastocytosis)