Diagnosis and treatment of osteoporosis

A new definition of osteoporosis has been proposed by an expert panel of the World Health Organization, in which cutoff diagnostic and therapeutic values are derived from bone mass measurements, leading to the practical idea of densitometric osteoporosis with or without fractures. At the individual level, risk factors of bone fragility are not accurate enough to allow definition of an "at risk" population. Thus, bone densitometry remains the major parameter to be analyzed. In terms of therapy, all protocols refer to the more academic definition of osteoporosis, so that no true innovation appeared in the literature over the past year. The roles of calcium, exercise, hormone replacement therapy, calcitonin, fluoride, and bisphosphonates are more accurately defined in established osteoporosis. However, new studies are needed in the investigation of densitometric osteoporosis.