OSTEOPOROSIS - DEFINITION AND CLINICAL PRESENTATION

Osteoporosis is a skeletal condition characterized by decreased densit y (mass/volume) of normally mineralized bone. The reduced bone density leads to decreased mechanical strength, thus making the skeleton more likely to fracture. Postmenopausal osteoporosis (Type I) and age-rela ted osteoporosis (Type II) are the most common primary forms of bone l oss seen in clinical practice. Secondary causes of osteoporosis includ e hypercortisolism, hyperthyroidism, hyperparathyroidism, alcohol abus e, and immobilization. In the development of osteoporosis, there is of ten a long latent period before the appearance of the main clinical ma nifestation, pathologic fractures. The earliest symptom of osteoporosi s is often an episode of acute back pain caused by a pathologic verteb ral compression fracture, or an episode of groin or thigh pain caused by a pathologic hip fracture. In the diagnostic process, the extent an d severity of bone loss are evaluated and secondary forms of bone loss are excluded. A careful diagnostic work-up that includes clinical his tory, physical examination, laboratory evaluation, bone densitometry, and radiographic imaging will allow the clinican to determine the caus e of osteoporosis and to institute medical interventions that will sta bilize and even reverse this frequently preventable condition.