Osteoporosis: detection, prevention, and treatment in primary care.

Osteoporosis is a silent disease that often remains asymptomatic and undetected until bone fracture occurs. Because of the high morbidity associated with fracture, prevention is a clinical priority. In order to identify those who would benefit from therapeutic intervention, bone density measurement is indicated in patients with risk factors for osteoporosis. Therapies include hormone replacement, calcitonin, bisphosphonates, and selective estrogen receptor modulators, as well as exercise and supplements of calcium and vitamin D. The goal of all treatments is to decrease the risk of fracture by minimizing bone loss and increasing bone mass.