骨粗鬆症の診断と治療

抄録

In Japan, since the number of patients with osteoporosis totals more than 10 million, we have numerous chances to examine such patients.
In this review, I would like to describe the diagnosis and treatment of osteoporosis based on up-to-date knowledge.
Patients with osteoporosis usually complain of chronic back or lower back pain.
Pain in patients with osteoporosis is brought about by fractures due to osteoporotic (fragile) bone. Common fractures seen in osteoporosis are those of the proximal femur, proximal humerus, vertebral body, and distal end of the radius.
Diagnosis should be established based on the findings of X-ray images of the lumbar spine or proximal femur and bone mineral density (BMD) in accordance with the diagnostic criteria proposed in 2000 by the Japanese Society for Bone and Mineral Research.
The aim of osteoporosis treatment is to prevent fractures complicated with compromised bone strength. Preventing the loss of activities in daily life, the quality of life of patients with osteoporosis must be maintained.
Now, we are able to prescribe two kinds of drug to increase the BMD and prevent fractures: bisphosphonates and SERM (selective estrogen receptor modulator). Sufficient evidence for the efficacy of both drugs has been accumulated, and they are strongly recommended.