This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lata, P. F. Articles by Elliott, M. E. Search for Related Content PubMed PubMed Citation Articles by Lata, P. F. Articles by Elliott, M. E. Social Bookmarking                   What's this?

Patient Assessment in the Diagnosis, Prevention, and Treatment of Osteoporosis

Paul F. Lata, PharmD^* and Mary E. Elliott, PharmD, PhD^,

^* Bay Area Medical Center, Case Management Services, Marinette, Wisconsin; the University of Wisconsin-Madison School of Pharmacy; and William S. Middleton Veterans Affairs Medical Center, Madison, Wisconsin

Correspondence: Paul F. Lata, PharmD, Bay Area Medical Center, Case Management Services, 3100 Shore Drive, Marinette, WI 54143. Electronic mail may be sent to plata{at}bamc.org.

Assessment of the patient with osteoporosis includes history and physical examination, laboratory testing, and imaging studies. Information gathered during this assessment assists clinicians in targeting strategies to prevent fractures. The medical history should contain items such as personal and family history of fractures, lifestyle, intake of substances such as vitamin D, calcium, corticosteroids, and other medications. The physical examination can reveal relevant information such as height loss and risk of falls. Bone mineral density (BMD), most commonly determined by dual-energy x-ray absorptiometry, best predicts fracture risk in patients without previous fracture. BMD testing is most efficient in women over 65 years old but is also helpful for men and women with risk factors. Serial BMD tests can identify individuals losing bone mass, but clinicians should be aware of what constitutes a significant change. Laboratory testing can detect other risk factors and can provide clues to etiology. Selection of laboratory tests should be individualized, as there is no consensus regarding which tests are optimal. Biochemical markers of bone turnover have a potential role in fracture risk assessment and in gauging response to therapy, but are not widely used at present. Clinicians should be aware of problems with vitamin D measurement, including seasonal variation, variability among laboratories, and the desirable therapeutic range. Careful assessment of the osteoporotic patient is essential in developing a comprehensive plan that reduces fracture risk and improves quality of life.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. L. Hague and R. Touger-Decker Weighing in on Weight Screening in the Dental Office: Practical Approaches J Am Dent Assoc, July 1, 2008; 139(7): 934 - 938. [Abstract] [Full Text] [PDF]

				W. W. K. Koo Bone Deficit and Bone Health Nutr Clin Pract, June 1, 2007; 22(3): 259 - 260. [Full Text] [PDF]