[Diagnosis, prevention and therapy of osteoporosis]

Osteoporosis is a generalized osteopathy manifesting itself mainly in women beyond 60 years of age. We still lack a uniform definition of osteoporosis, generally defined as a decrease in bone mass in comparison with an age- and sex-related norm with normal mineralization of the remaining bone tissue. Of great importance for diagnosis are, above all, radiological procedures (plain X-rays of the spine, photon absorptiometry, computerised tomography), besides the medical history (backache, fractures) and the physical examination (kyphosis, shortening of the trunk, decrease in height). Furthermore, analyses of clinical chemistry and eventually histological examinations have to be applied for differential diagnostics with other generalized osteopathies and for etiological classification. The therapy of osteoporosis is supported by two main components: therapy of pain and influence on bone metabolism in order to diminish the risk of fractures. The position of fluorides in the treatment of osteoporosis is still under discussion. Most recent results recognize an alternative possibility by use of diphosphonates. Hormone substitution, physical training and nutritional aspects come to the fore in the prophylaxis of osteoporosis.