review article Office Practice of Osteoporosis Evaluation

Osteoporosis is a metabolic disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Bone fragility depends on bone density, turnover and microarchitectural fea- tures, such as relative trabecular volume, spacing, number and connec- tivity. Previous fragility fractures increase the fracture risk irrespective of bone density. Other risk factors must also be considered as many frac- tures occur in patients with osteopenia on densitometry. On the other hand, the diagnosis of osteoporosis and increased fracture risk should not be based on densitometric data alone when young populations such as men below 65 years, premenopausal women, adolescents and children are considered. (Arq Bras Endocrinol Metab 2006;50/4:674-684)