Osteoporosis in Routine Clinical Practice – from Etiopathogenesis to Treatment

Although clinical signs of osteoporosis can be identified even in the oldest skeletons ever discovered—suggesting that this disease is as old as humankind itself—the term and its formal description are much more recent. The term “osteoporosis” was first introduced in 1935 by the French physician Jean Lobstein to describe bone changes identified in a patient with “blue sclerae,” most likely a case of osteogenesis imperfecta.
In 1941, the American endocrinologist Fuller Albright reported the case of a patient with vertebral fractures occurring after oophorectomy, in whom estrogen therapy prevented the development of new compressions. Later, in a 1947 publication, the same physician proposed the first definition of osteoporosis, describing it as a “decrease in the amount of bone that is otherwise qualitatively normal”. This distinction was important at the time, as it
differentiated osteoporosis from osteomalacia, which is characterized by defective mineralization.
Currently, osteoporosis is defined as a “skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture.”

Contents

1. Osteoporosis: General Data
2. Clinical Manifestations – Fragility Fracture
3. Methods of Evaluation in Osteoporosis
4. FRAX – 10-Year Fragility Fracture Risk Assessment
5. Therapeutic Options in Osteoporosis
6. Therapeutic Indications in Osteoporosis – Who Should Be Treated?
7. Commented Clinical Cases
8. Knowledge Assessment
9. References