ASSESSMENT AND MANAGEMENT OF THE PATIENT WITH OSTEOPOROSIS

This article presents a clinical approach to the diagnosis and management of the patient with osteoporosis. Initially, a complete medical history, including assessment of the impact of osteoporosis on activities of daily living and psychologic function, physical examination, and appropriate laboratory evaluation is required. Subsequently, the goals of osteoporosis treatment are pain control, maximization of function, maintenance of bone mass, and fracture prevention. These goals may be best achieved by multidisciplinary team effort. Nutritional status, with emphasis on calcium and vitamin D intake, is assessed and optimized. A program of exercise to increase muscle strength and endurance is initiated. Patient education regarding proper body mechanics, fall prevention, and osteoporosis in general is provided. Finally, an assessment of fall risk and appropriate medical therapy aimed at preservation of bone mass is instituted.