Osteoporosis

Osteoporosis is a major public health problem and the clinical consequence is fracture. The most common fractures are of the proximal femur, distal forearm and vertebral body. These fractures are more common in older individuals, particularly in women. The key risk factors such as family history or prior history of fracture are triggers for the measurement of bone mineral density. Measurement of the femoral neck is used as the basis for the definition of osteoporosis; a value that is 2.5 standard deviations of more below the mean value for young people is considered 'osteoporosis'. There are a number of diseases and drugs that can cause osteoporosis such as primary hyperparathyroidism and glucocorticoid therapy, and the patient should be assessed for these conditions before treatment is started. The current treatments include antiresorptive treatments such as bisphosphonates that work by preserving the microarchitecture of bone, and anabolic treatments that work by rebuilding the microarchitecture.