[Clinical surveillance of osteoporotic patients]

The diagnosis of osteoporosis is often not considered, while many different pathophysiological conditions, as well as diseases, can determine or at least predispose to this syndrome. A detailed surveillance as well as an appropriate consideration of the general state of health and of the clinical history of the patient are therefore mandatory. Once established the diagnosis of osteoporosis, precise therapeutical directions are necessary as well as preventive strategies for evaluation of the disease and for the damages that can be derive: the fractures. It is a must to follow defined habits regarding life's style (i.e. appropriate diet, physical exercise, sun exposure, abstinence from drugs and excess of alcohol). Moreover, considering the age, the situation of the single patient as well as the results of specific tests (i.e.: densitometry, X-ray, biochemical markers of bone metabolism), the first step is whether it is appropriate to start a therapy with antiresorptive drugs. It takes a long lasting therapeutical intervention, either for years or sometimes for the entire life, in order to avoid fractures due to osteoporosis. These events are to be considered as the most dangerous consequences of osteoporosis, since they can worsen life's quality and cause a great burden of personal sufferance and of economical costs for the community. During these long lasting pharmacological interventions, the patients has to be checked at the appropriate time (usually every 18 months in terms of DXA), and at the most informative skeletal sites, in general the hip and the lumbar spine. Osteoporosis is a severe and chronic disease, and the related fractures impose an accurate consideration and surveillance by physicians. The patient has to be motivated by clear information of the risks related to disease, in order to obtain a good compliance as regards the above mentioned therapy and life's style habits.