Osteoporosis

Osteoporosis is a fundamental problem of the ageing population and is not confined to women - it can also be caused by certain drugs such as steroids and anticoagulants, inactivity and hormonal disarrangement. Recent advances in knowledge of etiology, pathophysiology, diagnosis and prevention, such as exercise and mechanical loading, can now be applied to patient care to prevent the skeletal complications such as fracture and vertebral compression. This contemporary update covers the clinical implications of these latest developments for the edocrinologist, gynaecologist, rheumatologist and all those associated with the older patient. Emphasis is placed on the role of excessive cytokine production as a causative factor; new methods of bone densitometry; new markets for bone resorption for assessment of bone density; new trends in pharmacotherapy, with much detail on the controversial role of estrogen, calcitonin and fluoride; and preventive methods such as exercise and mechanical loading.