The Antiquity of Osteoporosis: More Questions than Answers

Abstract

The year 1995 will be the centennial of the discovery of X-rays by Roentgen (1845–1923). X-ray is the most commonly used approach for the diagnosis of osteoporosis: it not only helps to detect and discriminate fractures, but also serves to approximate bone rarefaction in severe forms of osteoporosis [1]. When X-ray and the subsequent techniques were not available, the diagnosis of osteoporosis could not be established. (Yet the term osteoporosis was employed by pathologists in the mid-nineteenth century and was clearly distinguished from osteomalacia by Pommer almost 100 years ago [2].) But does this mean that osteoporosis did not exist before? Paleopathologic examinations of old skeletons seem to indicate that vertebral fractures were relatively uncommon [2, 11], certainly less common than limb fractures [3]. But is this approach sufficiently sensitive to detect osteoporosis?