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When I was a young intern in internal medicine,osteoporosis was defined mainly as a fracture occurring in elderly people. However,although plain X-ray examination was recognized as an insensitive way to detect osteoporosis, hypodense bone was already considered as the reflection of the disease. Over the past 20 years, con siderable progress has been accomplished. In terms of prevalence, incidence, risk factors, and the burden of osteoporosis and low-energy fracture, we can appreciate the magnitude of the problem and its impact on quality oflife. Weare wellaware that vertebral fracture, which can be acutely associated with a low clinical expression, leads to significant long-term impairments. The costs for the individual and for the health budget, Le. society,are estimated better. Wenow have a clear definition of the disease, such as low bone mass and architectural defects, resulting in increased fragility. For the former part of the definition, the clinician can use accurate and pre cise tools allowing them to distinguish how their patient's bone mineral content differs from that of a young healthy population in which fracture occurs very rarely. For the second series of fragility determinants, i. e. structure, methods are in rapid progress and will provide information to clinicians on these variables in the near future. Basicand clinical research have allowed major improvements in the understand ing of the pathophysiology of the disease. Newgenes implicated in lowand/or high bone mass have been characterized.
List of contents
I General aspects of bone, osteoporosis and fractures.- 1 Normal Skeletal Structure and Function.- 2 Physiology of Calcium Homeostasis and Bone Remodeling.- 3 Biomechanics of Bone and Fracture.- 4 Pathophysiology of Fractures.- 5 Epidemiology of Osteoporotic Fractures.- 6 Socioeconomic Impact.- 2 Investigations in Osteoporosis.- 7 Bone Densitometry, Radiography, and Quantitative Ultrasound for the Diagnostic Assessment of Osteoporosis.- 8 Biochemical Indices of Bone Turnover.- 9 Dual-energy X-ray-based Absorptiometry in Daily Clinical Practice.- 10 Differential Diagnos is: Back Pain and Osteoporosis.- 11 Differential Diagnosis: Bone Pain and Fractures.- 12 Falls in Older People.- 13 Genes and Osteoporosis.- 3 Treatment of Postmenopausal Osteoporosis.- 14 Prevention Early After Menopause.- 15 Pharmacologic and Non-pharmacologic Strategies to Prevent Hip Fracture in Old Age.- 16 Selective Estrogen Receptor Modulators.- 17 Bisphosphonate Therapy for Postmenopausal Osteoporosis.- 18 Anabolic Drug Therapy in Osteoporosis.- 19 Surgical Therapy of Fractures.- 4 Other Aspects of Osteoporosis.- 20 Osteoporosis in Men.- 21 Corticosteroid Osteoporosis.- 22 Tumor Bone Diseases.- 23 Immobilization, Exercise, and Osteoporosis.- 24 Nutrition and Osteoporosis.- 25 The Menopause: A Woman's View.- 5 The Future of Diagnosis and Treatment of Osteoporosis.- 26 Future Developments: Risk Assessment.- 27 Future Therapies.- 28 How to Interpret New Data.
Summary
When I was a young intern in internal medicine,osteoporosis was defined mainly as a fracture occurring in elderly people. However,although plain X-ray examination was recognized as an insensitive way to detect osteoporosis, hypodense bone was already considered as the reflection of the disease. Over the past 20 years, con siderable progress has been accomplished. In terms of prevalence, incidence, risk factors, and the burden of osteoporosis and low-energy fracture, we can appreciate the magnitude of the problem and its impact on quality oflife. Weare wellaware that vertebral fracture, which can be acutely associated with a low clinical expression, leads to significant long-term impairments. The costs for the individual and for the health budget, Le. society,are estimated better. Wenow have a clear definition of the disease, such as low bone mass and architectural defects, resulting in increased fragility. For the former part of the definition, the clinician can use accurate and pre cise tools allowing them to distinguish how their patient's bone mineral content differs from that of a young healthy population in which fracture occurs very rarely. For the second series of fragility determinants, i. e. structure, methods are in rapid progress and will provide information to clinicians on these variables in the near future. Basicand clinical research have allowed major improvements in the understand ing of the pathophysiology of the disease. Newgenes implicated in lowand/or high bone mass have been characterized.
Additional text
From the reviews of the second edition:
"The authors have gathered a number of specialists in the field of osteoporosis to give us a general review of the latest clinical knowledge. … This book is of great value for every clinician dealing with osteoporosis in adults." (N. Allington, Acta Orthopædica Belgica, Vol. 71 (2), 2005)
"During the last 20 years, considerable progress has been made in the knowledge of osteoporosis in diagnosis as well as in treatment, be it preventive or curative. P. Geusens, P. N. Sambrook and R. Lindsay offer us a comprehensive analysis of the subject in their second edition of Osteoporosis in Clinical Practice." (L. Balabaud, European Journal of Orthopaedic Surgery & Traumatology, Vol. 16, 2006)
Report
From the reviews of the second edition:
"The authors have gathered a number of specialists in the field of osteoporosis to give us a general review of the latest clinical knowledge. ... This book is of great value for every clinician dealing with osteoporosis in adults." (N. Allington, Acta Orthopædica Belgica, Vol. 71 (2), 2005)
"During the last 20 years, considerable progress has been made in the knowledge of osteoporosis in diagnosis as well as in treatment, be it preventive or curative. P. Geusens, P. N. Sambrook and R. Lindsay offer us a comprehensive analysis of the subject in their second edition of Osteoporosis in Clinical Practice." (L. Balabaud, European Journal of Orthopaedic Surgery & Traumatology, Vol. 16, 2006)
