Changing measures to evaluate changing bone

Osteoporosis is a silent, progressive disease affecting millions of Americans, costing $23.5 billion annually (). Fragility fractures, painful and costly sequelae of osteoporosis, are frequently underdiagnosed and undertreated partially because of limited assessment measures. Currently, bone mineral density measured by dual-energy x-ray absorptiometry is the surrogate marker of bone health () but has shortcomings predicting fragility fractures. Bone turnover markers and magnetic resonance spectroscopy are promising techniques for earlier, more accurate assessment of bone physiology and structure. Bone turnover markers reflect the dynamic nature of living bone (), thus providing a more comprehensive picture of bone health. Magnetic resonance spectroscopy may hold predictive power in determining fast and slow bone mineral density losers (). The use of these tools may assist with diagnosis of osteoporosis, allowing earlier determination of the effectiveness of prescribed therapies to improve bone health.