APPROACH TO THE DIAGNOSIS AND MANAGEMENT OF OSTEOPOROSIS

NOF recommends a comprehensive approach to the diagnosis and management of
osteoporosis. A detailed history and physical examination together with BMD assessment,
vertebral imaging to diagnose vertebral fractures, and, when appropriate, the WHO 10-year
estimated fracture probability are utilized to establish the individual patient’s fracture risk.10

Therapeutic intervention thresholds are based on NOF’s economic analysis that takes into
consideration the cost-effectiveness of treatments and competition for resources in the U.S.11,12

The clinician’s clinical skills and past experience, incorporating the best patient-based research
available, are used to determine the appropriate therapeutic intervention. The potential risks
and benefits of all osteoporosis interventions should be reviewed with patients and the unique
concerns and expectations of individual patients considered in any final therapeutic decision.
Risk Assessment

All postmenopausal women and men age 50 and older should be evaluated for osteoporosis
risk in order to determine the need for BMD testing and/or vertebral imaging. In general, the
more risk factors that are present, the greater the risk of fracture. Osteoporosis is preventable
and treatable, but because there are no warning signs prior to a fracture, many people are not
being diagnosed in time to receive effective therapy during the early phase of the disease.
Many factors have been associated with an increased risk of osteoporosis-related fracture