Fast Five Quiz: Osteoporosis Prevention and Treatment

Herbert S. Diamond, MD


December 10, 2020

Figure 1. Osteoporosis fracture. Colored radiograph of the hip of an elderly woman with a fractured femur (lower right, red) caused by osteoporosis. The round femur head articulates with the pelvis at the hip socket (center). The femur is fractured at the neck between the head and shaft of the bone.

Aging and loss of gonadal function are considered the two most important factors that contribute to the development of osteoporosis. In women, bone loss has been shown to accelerate rapidly in the first years following menopause. The lack of gonadal hormones is believed to upregulate osteoclast progenitor cells, while estrogen deficiency leads to increased expression of RANKL by osteoblasts and decreased release of osteoprotegerin; increased RANKL leads to the recruitment of increased numbers of preosteoclasts, as well as increased activity, vigor, and lifespan of mature osteoclasts. Guidelines for bone density testing in postmenopausal women have been published.

Comorbidities, such as rheumatoid arthritis and systemic lupus erythematosus, can lead to the development of secondary osteoporosis. Up to one third of postmenopausal women, in addition to many men and premenopausal women, have a coexisting cause of bone loss and may require increased monitoring.

Learn more about factors involved in the development of osteoporosis.


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