Osteoporosis is a silent disease. Many patients are not having appropriate testing to diagnose osteoporosis or establish osteoporosis risk; and, too many patients are not being prescribed any of the effective therapies. Osteoporosis can be prevented and can be diagnosed and treated before any fracture occurs. Importantly, even after the first fracture has occurred, there are effective treatments to decrease the risk of further fractures. Prevention, detection, and treatment of osteoporosis should be a mandate of primary care providers. This revised guide is based largely on the WHO 10-year fracture risk model and an accompanying economic analysis prepared by the National Osteoporosis Foundation in collaboration with the WHO, the American Society of Bone and Mineral Research, and the International Society for Clinical Densitometry. This updated guide offers concise recommendations regarding prevention, risk assessment, diagnosis and treatment of osteoporosis in postmenopausal women and men age 50 and older. It includes indications for bone densitometry and fracture risk thresholds for intervention with pharmacologic agents. The guide also addresses secondary causes of osteoporosis which should be excluded by clinical evaluation. Furthermore, all individuals should follow the universal recommendations for osteoporosis prevention outlined in this guide.[Korean Journal of Bone Metabolism, 15(2): 99-107, 2008]
