Evaluation and treatment of postmenopausal osteoporosis

OBJECTIVES: To review the recent literature and develop a logical strategy with which to approach the diagnosis and treatment of osteoporosis, based on clinical evidence and accepted practices. METHODS: Published reports from 1983 through 1997 obtained by MEDLINE search were reviewed and analyzed by both authors. RESULTS: Osteoporosis is a widespread medical condition readily identifiable by current diagnostic modalities, including quantitative computed tomography, single and dual x-ray absorbtiometry, radio-absorbtiometry, and ultrasound. Properly implemented prevention and treatment strategies, such as calcium and vitamin D supplementation, exercises, hormone replacement therapy, alendronate, and calcitonin, may reduce the future fracture risk in many individuals. An algorithm is provided based on currently available clinical evidence for the evaluation and treatment of osteoporosis. CONCLUSIONS: Expanded use of currently available and emerging diagnostic and therapeutic modalities should lead to decreased fracture rates and a resultant increase in quality of life for patients with osteoporosis.