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Revista Brasileira de Ortopedia
versión impresa ISSN 0102-3616
SOUZA, Márcio Passini Gonçalves de. Osteoporosis diagnosis and treatment. Rev. bras. ortop. [online]. 2010, vol.45, n.3, pp. 220-229. ISSN 0102-3616. http://dx.doi.org/10.1590/S0102-36162010000300002.
An article regarding the latest understanding of osteoporosis (OP) runs the risk of quickly becoming obsolete due to the fact that research and studies about OP today are generating a great amount of interest in researchers, the pharmaceutical and medical equipment industries, governments, and even the WHO. Every orthopedist knows OP by its most deleterious effect, the osteoporotic fracture (FxOP). OP without a fracture does not arouse suspicion because it is a pathology with a nonspecific clinical profile. The FxOP has an economic cost (for treatment), a social cost (for its sequelae), and a medical cost (for deaths). Many fractures could be avoided by a diagnosis of OP prior to the first fracture and, therefore, many temporary and permanent disabilities could be avoided and many lives saved. Awareness of the risk factors for osteoporosis raises suspicion and bone densitometry aids diagnosis. Treatment should be based on the physiopathology of the disease. Likewise, in prevention or in treatment of OP, we should reduce the activity of osteoclasts or increase the activity of osteoblasts, or both. Treatment that reduces the incidence of fractures by improving bone's geometry and microarchitecture is ideal. Newly formed bone tissue must have good cellular and matrix quality as well as normal mineralization, a good ratio of mineralized (mechanically resistant) bone to non-mineralized (flexible) bone, and no accumulated damage. The ideal treatment should have a positive rate of remodeling and fast and lasting therapeutic effects. This effect must be easily detectable. It must be safe.
Palabras clave : Osteoporosis [physiopathology]; Osteoporosis [diagnosis]; Osteoporosis [prevention & control].