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Osteoporosis (Oxford American Rheumatology Library)

Ronald C. Hamdy (Author), E. Michael Lewiecki (Author). pp. 192. OUP USA, 2013. ISBN-13: 978-0199927708.

This concise handbook, written by two Physicians, provides an excellent basic overview of all aspects of osteoporosis including epidemiology, pathophysiology, identification of fracture risk, diagnosis and management. It also covers specific situations such as glucocorticoid-induced osteoporosis, hyperparathyroidism, premenopausal women, and osteoporosis in men, children and adolescents. It provides a comprehensive summary of current evidence. Each chapter includes a list of references (up to 2012). 

The lengthy list of potential underlying causes given in Chapter 5 serves as an effective reminder that not all osteoporosis is post-menopausal, and that statistically-derived assessments based on cohorts of post-menopausal women may not apply in other specialised situations, particularly when therapeutic decisions are being made. 

The sections on pharmacological management give detail on individual bisphosphonates. The discussion of other options is, relatively, less detailed, for example the use of oestrogen therapy in post-menopausal women, although all are covered.  The authors emphasise the importance of individualized decisions rather than undue over-reliance upon statistically generated results taken in isolation.  They also address the specific concerns with regard to bisphosphonate therapy (including atypical femoral shaft fractures, and the rare osteonecrosis of the jaw).

This handbook should serve as a useful, readily accessible, pocket-sized, guide for Orthopaedic surgeons, who are frequently faced with osteoporotic individuals in their daily practice.  It is well-written, clear, concise and easy to read.  It can serve as a useful guide to both management and referral, both for orthopaedic surgeons working in well – resourced settings where specialist support is readily available, and for those working in less-favoured circumstances who do not have easy access to such support.

Reviewed by Prof Clive Cockram