Osteoporosis: how to diagnose and what treatment to prescribe

Osteoporosis is the fourth most common disease in the world among people over 50 years old, and its social significance is associated with low-energy vertebrae and nonvertebrae fractures, leading not only to a deterioration in the patient’s quality of life, which may not return to the pre-fracture level for many years, but also to an increase in mortality. Currently, in real clinical practice, the diagnosis of osteoporosis continues to be based on measuring bone mineral density using dual-energy X-ray absorptiometry, while this type of equipment often remains unavailable in certain regions of our country. The article discusses the clinical criteria for the diagnosis of osteoporosis, provides mandatory and, if necessary, additional laboratory tests for patients, as well as recommendations for choosing an anti-osteoporotic medication. Special attention is paid to the need for additional intake of calcium and vitamin D in combination with all medications used to treat osteoporosis.