1;Preface;5 2;Contents;7 3;Epidemiology of Osteoporosis;11 3.1;1.1 Osteoporosis: A Silent Thief!;11 3.2;1.2 Osteoporosis: The Global Scope of the Problem;12 4;Biology of Bone;17 4.1;2.1 Bone: An Architectural Masterpiece;17 4.2;2.2 Bone: A Permanent Building and Rebuilding Site;20 4.3;2.3 Remodelling Units;25 4.4;2.4 Some Biological Perspectives on the Mechanisms Involved in the Control and Regulation of Bone Remodelling;27 4.5;2.5 Minimodelling;28 4.6;2.6 Stimuli, Triggers and Mechanisms of Activation of Bone Remodelling;29 4.7;2.7 Control of Bone Remodelling: A Network of Complex Mechanisms;30 4.8;2.8 Osteoimmunology: A Representative of Systems Biology;33 4.9;2.9 The RANK/RANKL/Osteoprotegerin System;33 4.10;2.10 Leptin: Role of the Central Nervous System in Regulation of Bone;35 4.11;2.11 Growth of the Embryo in the Uterus;36 4.12;2.12 Peak Bone Mass: An Investment for a Healthier Life;37 5;Pathogenesis of Osteoporosis;39 5.1;3.1 Factors in the Development of Osteoporosis;39 5.2;3.2 Def inition of Osteoporosis;40 5.3;3.3 Osteoporosis - Which Bones are Vulnerable?;41 5.4;3.4 Osteoporosis - Also a Question of Quality!;42 5.5;3.5 Definition of "Fracture";44 5.6;3.6 Vertebral ( Spinal) Fractures;44 5.7;3.7 Hip Fractures;46 5.8;3.8 Wrist Fractures;47 5.9;3.9 Other Fractures;47 6;Subgroups of Osteoporosis;48 6.1;4.1 According to Spread;48 6.2;4.2 According to Age and Sex;49 6.3;4.3 According to Extent;51 6.4;4.4 According to Histology;52 7;Risk Factors for Fractures;54 7.1;5.1 Risk Factors Which Cannot (yet) be Influenced;55 7.2;5.2 Risk Factors Which Can be Influenced;57 8;Clinical Evaluation of Osteoporosis;64 8.1;6.1 Indicative Symptoms;64 8.2;6.2 Osteoporosis and Teeth, Skin and Hair - What are the Connections?;66 8.3;6.3 Role of Conventional X- Rays in Osteoporosis;66 8.4;6.4 Other Useful Imaging Techniques;69 9;Bone Density in Osteoporosis;72 9.1;7.1 Why Measure Bone Mineral Density?;72 9.2;7.2 Which Instruments to Use?;72 9.3;7.3 Which Bones to Measure?;79 9.4;7.4 Who is Due or Overdue for a BMD Test?;79 9.5;7.5 Bone Densitometry in Children - Now Readily Available!;81 9.6;7.6 BMD Measurement - Not a Scary Procedure, Nothing to be Afraid of!;82 10;Laboratory Evaluation of Osteoporosis;83 10.1;8.1 Recommended Tests;83 10.2;8.2 Significance of Markers of Bone Turnover;83 10.3;8.3 Recommendations for Practical Use of Bone Markers;87 10.4;8.4 Potential of Bone Biopsy in Clinical Practice;87 10.5;8.5 When is a Bone Biopsy Indicated?;88 10.6;8.6 Up-to- Date Methods;89 11;Prevention of Osteoporosis;91 11.1;9.1 Step 1: First of all a Calcium- Rich Diet!;91 11.2;9.2 Step 2: Ensure an Adequate Supply of Vitamins!;93 11.3;9.3 Step 3: Protect the Spine in Everyday Life!;94 11.4;9.4 Step 4: Regular Physical Activity - for the Preservation of Strong Bones!;95 11.5;9.5 Step 5: No Smoking, Please!;98 11.6;9.6 Step 6: Reduce Nutritional " Bone Robbers"!;98 11.7;9.7 Step 7: Strive for an Ideal Body Weight!;99 11.8;9.8 Step 8: Identify Drugs that Cause Osteoporosis and Take Appropriate Steps to Counteract Them When Possible and Necessary!;100 11.9;9.9 Step 9: Recognize Diseases Which Damage Bones!;100 11.10;9.10 Step 10: Management of Patients Who Have Already Sustained a Fracture;101 12;Physical Activity and Exercise Programs;102 12.1;10.1 Strong Muscles Make and Maintain Strong Bones!;102 12.2;10.2 The Muscle- Bone Unit and Sarcopenia;103 12.3;10.3 Exercise Programs - Preventive and Restorative ;104 12.4;10.4 Implementation of a Training Program;104 13;Treatment Strategies in Osteoporosis;105 13.1;11.1 Evidence- Based Strategies for the Therapy of Osteoporosis;105 13.2;11.2 Comprehensive Approach to the Therapy of Osteoporosis;109 13.3;11.3 Indication for Treatment - Combining BMD with Clinical Factors;110 14;Management of Pain in Osteoporosis;112 14.1;12.1 Start with the Patient, not the Disease!;112 14.2;12.2 Acute Phase;112 14.3;12.3 Chronic Phase - Short Term;113 14.4;12.4 Chronic Phase - Long Term;114 14.5;12.5 Electric Potentials in