Volume 69 Number 4 September 2002	back to contents

Osteoporosis: Trends and Intervention	220-231
Angela M. Inzerillo, M.D.1, and Mone Zaidi, M.D., Ph.D.2

From the Mount Sinai Bone Program, Department of Medicine, Division of Endocrinology, and Department of Geriatrics, Mount Sinai School of Medicine, New York, NY; and Bronx Veterans Affairs Geriatrics Research Education and Clinical Center, Bronx, NY.

¹Instructor and ²Professor of Medicine and Geriatrics.

Address correspondence to Mone Zaidi, M.D., Ph.D., Box 1055, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029.

Based in part on a presentation given by Mone Zaidi, M.D., Ph.D., at Grand Rounds to the Department of Medicine, Mount Sinai School of Medicine, New York, NY on January 4, 2000 and updated as of September 2001.

ABSTRACT

Osteoporosis is a skeletal disorder in which bone strength is compromised due to loss of bone density and bone quality. It is the leading cause of serious morbidity and functional loss in the elderly. At times, it is difficult for the clinician to distinguish between the disease and normal skeletal aging, but advances in the scientific understanding of the underlying disease process have made management of osteoporosis a preventable disease for the most part. Defining the point at which these age-related skeletal changes require intervention presents a major challenge to researchers and clinicians alike. There are several reasons for these difficulties. There is a long period of bone loss before the onset of clinically apparent disease. Also current diagnostic procedures have been shown to distinguish those at risk of fracture and those not at risk, there is a large overlap in bone density between persons who experience fractures and those who do not. Research efforts directed at these issues have increased dramatically, as have developing technologies in the measurement and screening of bone mineral density. Ongoing advances in the therapeutic modalities have promoted new methods to treat this disorder.

The foregoing review will describe the mechanisms responsible for osteoporosis and the modalities used to screen and diagnose this common disorder. Various therapeutic approaches now in use, and some promising experimental trials, will be discussed.

KEYWORDS

Bisphosphonates, bones, bone remodeling, calcium, DEXA, fracture, estrogen, osteoporosis, postmenopausal osteoporosis.

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