Osteoporosis: disease, risk factor or hype?

The time for osteoporosis has come. In a recent editorial it was estimated that ‘the disease of the 21 century’ will increase more than twofold within this period. Until recently, healthcare providers have shown little interest in osteoporosis. The magnitude of the problem was not recognised; back pain and hip fractures were not considered sensational complaints or major events. The pathogenesis of bone fragility was largely unknown and difficult to study. Fractures observed on radiographs of the lumbar or thoracic spine were supposed to be the inevitable consequence of old age. Moreover, bone density could not be measured in a reliable way, and treatment showed no direct clinical results; it was merely confined to the prevention of new fractures. Some, but not all of this, has now changed.