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Introduction to Osteoporosis, Osteomalacia, and Fragility Fractures

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Abstract

Background

Osteoporosis is a disease of the bones leading to decreased bone mineral density, leading to fragility fractures. This article is an overview of osteoporosis, osteomalacia and fragility fractures and serves as an introductory article for this special issue on osteoporosis.

Methods

This is a short, comprehensive account of the given conditions with concepts and a review from the recent literature. The authors provide relevant references from the literature in the bibliography. The sections herein have also been deliberated in the meetings of experts of osteoporosis.

Results

An overview of osteoporosis, osteomalacia and fragility fractures is provided, including definitions and summaries of aetiology, pathophysiology, diagnosis, prevention, and management. A detailed account of some of these topics will be provided in subsequent chapters.

Conclusion

Osteoporosis is a silent disease with the potential to cause significant morbidity and mortality if not detected early. It is important to differentiate from and diagnose associated osteomalacia to provide accurate therapy. It is also important to identify the type of fragility fractures and initiate treatment for bone strengthening to prevent subsequent fractures.

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References

  1. Sözen, T., Özışık, L., & Başaran, N. Ç. (2017). An overview and management of osteoporosis. European Journal of Rheumatology, 4(1), 46–56.

    Article  PubMed  Google Scholar 

  2. Clynes, M. A., Harvey, N. C., Curtis, E. M., Fuggle, N. R., Dennison, E. M., & Cooper, C. (2020). The epidemiology of osteoporosis. British Medical Bulletin, 133(1), 105–117.

    PubMed  Google Scholar 

  3. Salari, N., Ghasemi, H., Mohammadi, L., et al. (2021). The global prevalence of osteoporosis in the world: A comprehensive systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 16, 609.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dobbs, M. B., Buckwalter, J., & Saltzman, C. (1999). Osteoporosis: The increasing role of the orthopaedist. Iowa Orthopaedic Journal, 19, 43–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Conference, C. (1984). Osteoporosis. Journal of the American Medical Association, 252, 799.

    Article  Google Scholar 

  6. Anonymous WHO Study Group. (1994). Assessment of fracture risk and its application to screening for post-menopausal osteoporosis. WHO.

    Google Scholar 

  7. Office of the Surgeon G. (2004). Reports of the Surgeon General. Bone health and osteoporosis: A report of the surgeon general. Office of the Surgeon General (US).

    Google Scholar 

  8. Downey, P. A., & Siegel, M. I. (2006). Bone biology and the clinical implications for osteoporosis. Physical Therapy, 86(1), 77–91.

    Article  PubMed  Google Scholar 

  9. Berger, C., Langsetmo, L., Joseph, L., Hanley, D. A., Canadian Multicentre Osteoporosis Study Research Group, et al. (2008). Change in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents. CMAJ, 178(13), 1660–1668.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Greenstein, A. S., & Gorczyca, J. T. (2019). Orthopedic surgery and the geriatric patient. Clinics in Geriatric Medicine, 35(1), 65–92.

    Article  PubMed  Google Scholar 

  11. Carey, J. J., Wu, P. C., & Bergin, D. (2022). Risk assessment tools for osteoporosis and fractures in 2022. Best Practice & Research Clinical Rheumatology, 36(3), 101775.

    Article  Google Scholar 

  12. Fathima, S. N., Tamilselvi, R., & Beham, M. P. (2020). Measurement of BMD in dual-energy X-ray absorptiometry—A review. International Research Journal of Innovations in Engineering and Technology., 4(3), 13.

    Google Scholar 

  13. Lewiecki, E. M. (2022). Evaluating patients for secondary causes of osteoporosis. Current Osteoporosis Reports, 15, 1–2.

    Article  Google Scholar 

  14. Burden, A. M., Tanaka, Y., Xu, L., Ha, Y. C., McCloskey, E., Cummings, S. R., & Glüer, C. C. (2020). Osteoporosis case ascertainment strategies in European and Asian countries: A comparative review. Osteoporosis International. https://doi.org/10.1007/s00198-020-05756-8

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kanis, J. A., Harvey, N. C., Johansson, H., Liu, E., Vandenput, L., Lorentzon, M., Leslie, W. D., & McCloskey, E. V. (2020). A decade of FRAX: How has it changed the management of osteoporosis? Aging Clinical and Experimental Research, 32, 187–196.

    Article  PubMed  Google Scholar 

  16. Chiodini, I., Merlotti, D., Falchetti, A., & Gennari, L. (2020). Treatment options of glucocorticoid-induced osteoporosis. Expert OpinPharmacother., 21, 721–732.

    Article  CAS  Google Scholar 

  17. Francis, R. M., & Selby, P. L. (1997). Osteomalacia. Baillieres Clinical Endocrinology and Metabolism, 11(1), 145–163.

    Article  CAS  PubMed  Google Scholar 

  18. Arboleya, L., Braña, I., Pardo, E., Loredo, M., & Queiro, R. (2023). Osteomalacia in adults: A practical insight for clinicians. Journal of Clinical Medicine, 12(7), 2714.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Uday, S., & Högler, W. (2020). Nutritional rickets & osteomalacia: A practical approach to management. The Indian Journal of Medical Research, 152(4), 356.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Janoušek, J., Pilařová, V., Macáková, K., Nomura, A., Veiga-Matos, J., da Silva, D. D., Remião, F., Saso, L., Malá-Ládová, K., Malý, J., et al. (2022). Vitamin D: Sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Critical Reviews in Clinical Laboratory Sciences, 59, 517–554.

    Article  PubMed  Google Scholar 

  21. Peacock, M. (2021). Phosphate metabolism in health and disease. Calcified Tissue International, 108, 3–15.

    Article  CAS  PubMed  Google Scholar 

  22. Cianferotti, L. (2022). Osteomalacia is not a single disease. International Journal of Molecular Sciences, 23(23), 14896. https://doi.org/10.3390/ijms232314896

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bhan, A., Qiu, S., & Rao, S. D. (2018). Bone histomorphometry in the evaluation of osteomalacia. Bone Reports, 17(8), 125–134.

    Article  Google Scholar 

  24. Dempster, D. W., Compston, J. E., Drezner, M. K., et al. (2013). Standardized nomenclature, symbols, and units for bone histomorphometry: A 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee. Journal of Bone and Mineral Research, 28(1), 2–17.

    Article  PubMed  Google Scholar 

  25. Florenzano, P., Gafni, R. I., & Collins, M. T. (2017). Tumor-induced osteomalacia. Bone Reports, 20(7), 90–97.

    Article  Google Scholar 

  26. Brown, J. P., & Josse, R. G. (2002). Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Canadian Medical Association Journal, 67(10 Suppl), S1–S34.

    Google Scholar 

  27. Kanis, J. A., et al. (2001). The burden of osteoporotic fractures: A method for setting intervention thresholds. Osteoporosis International, 12(5), 417–427.

    Article  CAS  PubMed  Google Scholar 

  28. Acevedo, C., Stadelmann, V. A., Pioletti, D. P., Alliston, T., & Ritchie, R. O. (2018). Fatigue as the missing link between bone fragility and fracture. Nature Biomedical Engineering, 2, 62–71.

    Article  PubMed  Google Scholar 

  29. Melton, L. J., Achenbach, S. J., Atkinson, E. J., Therneau, T. M., & Amin, S. (2013). Long-term mortality following fractures at different skeletal sites: A population-based cohort study. Osteoporosis International, 24, 1689–1696.

    Article  PubMed  Google Scholar 

  30. Watts, N. B. (2014). GLOW investigators insights from the global longitudinal study of osteoporosis in women (GLOW). Nature Reviews Endocrinology, 10, 412–422.

    Article  PubMed  Google Scholar 

  31. Kannegaard, P. N., van der Mark, S., Eiken, P., & Abrahamsen, B. (2010). Excess mortality in men compared with women following a hip fracture. national analysis of comedications, comorbidity and survival. Age and Ageing, 39, 203–209.

    Article  PubMed  Google Scholar 

  32. Jansson, K.-A., Blomqvist, P., Svedmark, P., Granath, F., Buskens, E., Larsson, M., & Adami, J. (2010). Thoracolumbar vertebral fractures in Sweden: An analysis of 13,496 patients admitted to hospital. European Journal of Epidemiology, 25, 431–437.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Trajanoska, K., & Rivadeneira, F. (2019). The genetic architecture of osteoporosis and fracture risk. Bone, 126, 2–10.

    Article  PubMed  Google Scholar 

  34. Burger, H., de Laet, C. E., van Daele, P. L., Weel, A. E., Witteman, J. C., Hofman, A., & Pols, H. A. (1998). Risk factors for increased bone loss in an elderly population: The Rotterdam study. American Journal of Epidemiology, 147, 871–879.

    Article  CAS  PubMed  Google Scholar 

  35. Johnell, O., & Kanis, J. A. (2004). An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporosis International, 15, 897–902.

    Article  CAS  PubMed  Google Scholar 

  36. Winner, S. J., Morgan, C. A., & Evans, J. G. (1989). Perimenopausal risk of falling and incidence of distal forearm fracture. BMJ, 298, 1486–1488.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Corso, P., Finkelstein, E., Miller, T., Fiebelkorn, I., & Zaloshnja, E. (2015). Incidence and lifetime costs of injuries in the United States. Injury Prevention, 21, 434–440.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Srinivas B. S. Kambhampati.

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Jha, S.S., Srivastava, A., Kambhampati, S.B.S. et al. Introduction to Osteoporosis, Osteomalacia, and Fragility Fractures. JOIO 57 (Suppl 1), 25–32 (2023). https://doi.org/10.1007/s43465-023-01015-0

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