Osteoporosis: diagnosis and prevention.

Osteoporosis affects about 8 million Americans, mostly women. The incidence and cost of the disease are rising as the population and its life expectancy increase. Each year 1.5 million individuals with osteoporosis suffer debilitating fractures of the spine, hip, or forearm. The primary health care provider is positioned to detect osteoporosis and its risk factors before signs and symptoms occur. Early detection can be achieved through any one of several diagnostic modalities, including bone mineral density tests and the use of biochemical markers. Once a clinician determines that a patient has many risk factors, bone mineral density testing should be performed. If the test results confirm the clinician's suspicion, therapeutic options should be discussed. Although treatment options exist, the most effective method of dealing with osteoporosis is prevention, including modification of risk factors (for example, diet and lifestyle) and the use of hormone replacement therapy, raloxifene, or alendronate therapy.