[On "2015 Guidelines for Prevention and Treatment of Osteoporosis". Diagnostic criteria of primary osteoporosis and the criteria for pharmacological treatment].

Diagnosis of osteoporosis is based on the bone mineral density (BMD) measurement and differential diagnosis. The most important clinical determinant of bone strength is BMD in the conditions without previous fractures. It is indispensable to measure BMD to prevent first fractures. On the other hand, previous osteoporotic fractures are known to be the risk factors for other fractures. Particularly, osteoporotic vertebral fractures and hip fractures increase the risk of fractures even after the adjustment with BMD. These are the reasons why the information about previous osteoporotic fracures are important in the diagnosis of osteoporosis. In the current guideline, the patients who are given the diagnosis of primary osteoporosis are the candidates of pharmacological treatment. In addition, the patients of osteopenia one of whose parents has the history of hip fractures or those with the 10-year risk of major osteoporotic fractures of FRAX® are also considered to be the candidates of pharmacological treatment.