Diagnosis and management of osteoporosis.
Osteoporosis is a common disorder with significant morbidity and mortality. Clinical risk factors can identify patients most likely to have osteoporosis. Patients who have decreased bone mass are candidates for calcium and vitamin D supplementation; those who have more severe bone loss should be screened for secondary causes and started on medical therapy. First-line therapy most often is a bisphosphonate. Estrogen reduces hip fractures in women. Recombinant parathyroid hormone is reserved for patients who have failed or are not candidates for bisphosphonate therapy. Follow-up dual-emission x-ray absorptiometry is reserved for when a change in bone mineral density will make a difference in therapy.
Lash
Robert W
RW
Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical School, 3920 Taubman Center, Ann Arbor, MI 48109-0354, USA. rwlash@umich.edu
Nicholson
Jane M
JM
Velez
Lourdes
L
Van Harrison
R
R
McCort
Jane
J
D015502:Absorptiometry, Photon; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000627:therapeutic use; D016387:Women's Health
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium