Osteoporosis: a treatable disease.

Osteoporosis twenty years ago was a very different disease from what we know of it today. At that time a diagnosis of osteoporosis was made at the point of sustaining a fracture as there was no routine method of pre-fracture diagnosis such as bone mineral density measurement. Biochemistry was unhelpful as osteoporosis was associated with few biochemical abnormalities. For example, serum calcium, phosphate and alkaline phosphatase were usually normal. Bone histology was virtually the only way of diagnosing osteoporosis early. Simple radiography could detect fractures but radiological osteopenia was a late finding. The emergence of technology to accurately measure bone mineral density represented an important advance in the management of osteoporosis.