Abstract

Osteoporosis is an extraordinarily common disorder which is the main pathoegenetic factor associated with fractures which occur in approximately 50% of Caucasian women and 20% of Caucasian men over the aged of 50. Over the last 25-years the management of the condition has evolved dramatically firstly because of the development of effective bone measurement tools and secondly because of the launch of a slew of effective drugs which improve bone mass and reduce fracture rates.

This presentation will describe how to make use of bone density measurements particularly dual-energy x-ray absorptiometry (DXA) along with lateral spine DXA images and risk assessment tools, such as FRAX, to identify those men and women who should be treated. It will then outline the optimum currently available treatments which can be used including the bisphosphonates, strontium ranelate. parathyroid hormone and denosumab as well as how to assess response to therapy. Finally it will address current controversies especially some of the current anxieties on safety of the medications used and the thorny question of “how long to treat?”.