Investigating suspected osteoporosis

One may suspect osteoporosis for many reasons. One may identify a woman who has had a fracture that has resulted from minimal trauma; she may have had a radiograph that raises the issue of vertebral fracture or osteopenia; she may have a strong family history of osteoporosis; she may have a disease (such as premature ovarian failure) or be taking drugs (such as glucocorticoids) that are strongly associated with osteoporosis. In all of these situations, it is important to consider the possibility of osteoporosis and to refer for bone densitometry. A common form of presentation of more severe osteoporosis is a woman presenting with vertebral fracture - the paper begins by considering this clinical presentation. It then assesses the types of deformity, followed by the deformities that mimic fractures. Finally, the review article considers the use of vertebral morphometry in the clinic.