Osteoporosis and the Primary Care Physician: Time To Bone Up
Authors: Michael Kleerekoper
Journal: Annals of Internal Medicine (1995)

Editorials15 September 1995Osteoporosis and the Primary Care Physician: Time To Bone UpMichael Kleerekoper, MDMichael Kleerekoper, MDWayne State University Detroit, MI 48201Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-6-199509150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The magnitude of the community health problem posed by osteoporosis has been amply documented in the medical literature and the lay press. If one believes the numbers—and there is scant reason not to-it is clear that responsibility for the diagnosis, evaluation, and management of osteoporosis must quickly shift from the specialist to the primary care physician. More than 8 million persons in the United States are currently affected by osteoporotic fractures [1], and an otherwise healthy 50-year-old white woman has a 50% cumulative lifetime risk for sustaining at least one such fracture [2]. As with all diseases that are so ...References1. Melton LJ 3d. How many women have osteoporosis now? J Bone Miner Res. 1995; 10:175-7. Google Scholar2. Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989; 149:2445-8. Google Scholar3. Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD. Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporos Int. 1993; 3:120-6. Google Scholar4. Gluer CC, Vahlensieck M, Faulkner KG, Engelke K, Black D, Genant HK. Site-measured calcaneal measurements of broad-band ultrasound attenuation and single x-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res. 1992; 7:1071-9. Google Scholar5. Kleerekoper M, Nelson DA, Flynn MJ, Pawluszka AS, Jacobsen G, Peterson EL. Comparison of radiographic absorptiometry with dual energy x-ray absorptiometry and quantitative computed tomography in normal older white and black women. J Bone Miner Res. 1994; 9:1745-9. Google Scholar6. Ross PD, Davis JW, Epstein RS, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991; 114:919-23. Google Scholar7. Storm T, Thamsborg G, Steiniche T, Genant HK, Sorensen OH. Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med. 322:1265-71. Google Scholar8. Watts NB, Harris ST, Genant HK, Wasnich RD, Miller PD, Jackson RD, et al. Intermittent cyclical etidronate treatment of postmenopausal osteoporosis. N Engl J Med. 1990; 323:73-9. Google Scholar9. Pak CY, Sakhaee K, Adams-Huet B, Piziak V, Peterson RD, Poindexter JR. Treatment of postmenopausal osteoporosis with slow-release sodium fluoride. Final update of a randomized, controlled trial. Ann Intern Med. 1995; 123:401-8. Google Scholar10. Pak CY, Sakhaee K, Piziak V, Peterson RD, Breslau NA, Boyd P, et al. Slow-release sodium fluoride in the management of postmenopausal osteoporosis. A randomized, controlled trial. Ann Intern Med. 1994; 120:625-32. Google Scholar11. Riggs BL, Hodgson SF, O'Fallon WM, Chao EY, Wahner HW, Muhs JM, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med. 1990; 322:802-9. Google Scholar12. Kleerekoper M, Peterson EL, Nelson DA, Phillips E, Schork MA, Tilley BC, et al. A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporos Int. 1991; 1:155-61. Google Scholar13. Kleerekoper M, Balena R, Foldes J, Shih M, Rao D, Parfitt AM. Histomorphometric changes in iliac bone induced by sodium fluoride therapy depend on cumulative dose [Abstract]. J Bone Miner Res. 1990; 5(Suppl 2):267. Google Scholar14. Grynpas MD, Cheng PT. Fluoride reduces the rate of dissolution of bone. Bone Miner. 1988; 5:1-9. Google Scholar15. Lafage MH, Balena R, Battle MA, Shea M, Seedor JG, Klein H, et al. Comparison of alendronate and sodium fluoride effects on cancellous and cortical bone in minipigs. A one-year study. J Clin Invest. 1995; 95:2127-33. Google Scholar16. Sogaard CH, Mosekilde L, Richards A, Mosekilde L. Marked decrease in trabecular bone quality after five years of sodium fluoride therapy—assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients. Bone. 15:393-9. Google Scholar17. Kleerekoper M, Mendlovic DB. Sodium fluoride therapy of postmenopausal osteoporosis. Endocr Rev. 1993; 14:312-23. Google Scholar18. Pouilles JM, Tremollieres F, Causse E, Louvet P, Ribot C. Fluoride therapy in postmenopausal osteopenic women: effect on vertebral and femoral bone density and prediction of bone response. Osteoporos Int. 1991; 1:103-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Michael Kleerekoper, MDAffiliations: Wayne State University Detroit, MI 48201Current Author Address: Michael Kleerekoper, MD, Department of Internal Medicine, Harper Hospital, Wayne State University, 3990 John R., 1 Webber South, Detroit, MI 48201. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Postmenopausal Osteoporosis with Slow-Release Sodium Fluoride: Final Report of a Randomized Controlled Trial Charles Y.C. Pak , Khashayar Sakhaee , Beverley Adams-Huet , Veronica Piziak , Roy D. Peterson , and John R. Poindexter Metrics Cited byÖsterreichischer Leitfaden zur medikamentösen Therapie der postmenopausalen Osteoporose – Update 2009Interventions for OsteoporosisOsteoporosis health-related behaviors in secular and orthodox Israeli Jewish womenDirections of Drug Discovery in OsteoporosisEstrogens and OsteoporosisEffect of Two Training Regimens on Bone Mineral Density in Healthy Perimenopausal Women: A Randomized Controlled Trial 15 September 1995Volume 123, Issue 6Page: 466-467KeywordsBoneClinical trial reportingDrugsFood and Drug AdministrationOsteoporosisPhoton absorptiometryPrimary care physiciansSkeletonSodiumSpine ePublished: 15 August 2000 Issue Published: 15 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...