Osteoporosis: Diagnostic and Therapeutic PrinciplesClifford J. Rosen LA WRENCE G. RAISZ, MD Division of Endocrinology and Metabolism, University of Connecticut Health Center. Farmington. CT The rapid transfer of new knowledge concerning the pathogenesis, diagnosis, preven tion, and treatment of disease into clinical practice has always been a major challenge in medicine. This challenge is particularly difficult to meet in osteoporosis, not only because has been so much new knowledge generated in recent years, but also because this there disorder has not caught the attention of many practicing physicians. The goal of this volume is to help primary care physicians develop a better understanding of osteoporosis and a more effective approach to diagnosis, prevention, and treatment. As primary care physicians become more and more responsible for the maintenance of health and the prevention of disease, osteoporosis must become one of their important concerns. The magnitude of the problem of osteoporosis has been widely publicized. Within the next 30 years, the cost of hip fractures alone is expected to exceed $40 billion a year in the United States and will be a major cause ofincreased mortality. In addition, vertebral crush fractures will cripple more and more of our elderly population, both men and women. This enormous toll is not inevitable. Current methods of identifying individuals at risk and applying preventive programs could reduce the incidence offractures by 50% or more. This should be the minimum goal of clinicians. |
Contents
The Cellular and Biochemical Aspects of Bone Remodeling | 3 |
The Role of Calcium Phosphorus and Macronutrients | 17 |
Vitamin D in Health and Prevention of Metabolic | 29 |
THE PATHOPHYSIOLOGY OF OSTEOPOROSIS | 47 |
BETSY LOVE MCCLUNG RN MN Oregon Osteoporosis Center Providence Medical | 75 |
What Is an Osteoporotic Fracture? | 79 |
Bone Densitometry Techniques in Modern Medicine | 89 |
Clinical Interpretation and Utility of Bone Densitometry | 113 |
THE TREATMENT OF OSTEOPOROSIS | 145 |
Use of Estrogen for Prevention and Treatment | 159 |
Drug Therapy | 173 |
Nonpharmacologic Therapy for Osteoporosis | 189 |
CASE PRESENTATIONS | 203 |
Bone Mass in Renal Disease | 271 |
Glossary | 287 |
293 | |
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Common terms and phrases
absorptiometry activity alendronate assessment biochemical markers bisphosphonates bone density bone formation bone loss bone mass bone mass measurement Bone Miner Res bone mineral density bone remodeling bone resorption bone turnover breast cancer Calcif Tissue Int calcitonin calcium intake calcium supplementation Clin Endocrinol Metab clinical collagen cortical decrease densitometry diagnosis dietary calcium dose drugs elderly women Engl estrogen replacement exercise fall femoral neck femur fluoride fracture risk Genant HK glucocorticoid glucocorticoid osteoporosis hip fracture hypogonadism increased bone intervention levels low bone mass lumbar spine markers of bone menopause mg/d Miner Res 1994 muscle normal osteoblasts osteocalcin osteopenia Osteoporosis Int osteoporotic fractures photon placebo postmenopausal osteoporosis postmenopausal women predict prevention proximal femur pyridinoline quantitative radiographic rate of bone reduced renal Riggs BL risk factors serum studies testosterone therapeutic trabecular bone treatment of osteoporosis trials ultrasound urinary vertebral fractures X-ray