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Summary Bone densitometry is an indispensable key technology for the assessment of osteoporosis. In the areas of diagnosis of osteoporosis, quantification of fracture risk assessment, identification of subjects to treat, and monitoring of treatment, bone densitometry can provide valuable information not attainable by other diagnostic approaches. Both technique-specific and...
Summary The development of new biochemical markers of bone metabolism has greatly enriched the array of analytes used in the assessment of skeletal pathologies. When applied and interpreted correctly, these indices may be useful in the work-up of patients with metabolic or malignant bone disease. Although they are not suitable for establishing the diagnosis of osteoporosis...
Summary The introduction of DXA in daily clinical practice is a major advance in the case-finding of patients at high risk for osteoporosis. DXA measurements are helpful for the diagnosis of osteoporosis and for predicting fracture risk. In the absence of a prevalent vertebral fracture, DXA is essential for selecting patients for drug treatment. Low...
Summary Vertebral fracture due to underlying osteoporosis is an important cause of back pain. Other reasons for fracture should always be excluded. Vertebral osteoporosis presents clinically in only about 30% of affected people and is more often an incidental finding, despite being associated with disability. The impact increases with increasing number of vertebral fractures...
Summary Bone pain is a very common feature of many metabolic bone diseases, including metastatic bone disease, osteoporosis, and Paget’s disease of bone. The mechanism of pain is complex and depends on an increasing number of interrelated pathways and mediators. In general terms, bone pain can be categorized as arising from one a direct action on bone nociceptors...
Summary Falls are a multifactorial phenomenon, and subsequently assessment of risk factors for falls and implementation of preventive strategies need to reflect this. A number of large prospective studies have determined key risk factors for falling, many of which are amenable to correction. In terms of single risk factor interventions, exercise has been found to be effective,...
Summary Genetic factors play an important role in the regulation of bone mass and in the pathogenesis of osteoporosis. Twin and family studies have shown that 50–85% of the variance in BMD is determined genetically, and molecular genetic studies have identified several candidate genes and quantitative trait loci that are involved in this process. The most widely studied candidate...
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