Foreword

The dramatic increase in the incidence of osteoporosis requires up-to-date knowledge of the newest perspectives and the most recent developments in diagnosis and treatment of osteoporotic patients. Bone mineral density is closely related to bone fragility, and the advent of techniques to quantitatively assess bone density has been welcomed, reducing the subjectivity inherent in conventional radiologic assessment of osteoporosis. The ongoing technical process has made various techniques of assessing bone density widely available. These measurement techniques, however, have also incurred some criticism because bone densitometry has sometimes been applied without specific indications and without appropriate clinical ramifications.

Osteoporosis is a disease characterized by reduced bone mass, quality, and strength; changes in skeletal microarchitecture; and increased fracture risk. Osteoporosis, which literally means porous bone, is often referred to as the silent disease because symptoms are not noticed until a fracture occurs. A tremendous comprehensive effort has been made in the past 2 decades to improve diagnostic methods, increase awareness, and identify treatments for osteoporosis.

Recently, thanks to my role as expert and technical consultant to the Italian Department of Health, I began considering osteoporosis a fundamental matter to be faced in terms of primary, secondary, and tertiary prevention by conducting an information campaign in schools and, among many other interventions, the creation, for the first time in history, of a registry of fragility fractures of all skeletal segments.

One of the great merits of this issue is that it deals with all aspects of osteoporosis, including morphology and function, providing a perspective on the current status of bone densitometry and its relevance to osteoporosis diagnosis and management. Aside from standard bone densitometry, newer technologies, such as quantitative ultrasound techniques, MR imaging, multidetector CT, and bone structure analysis, are discussed in the context of diagnosing osteoporosis.

I am especially grateful to the authors, who are among the most prominent and knowledgeable in this particular scientific field, for their effort and dedication. The outstanding qualifications and high level of expertise of the editor, Professor Giuseppe Guglielmi, and of the contributing authors are a guarantee for the up-to-date and comprehensive contents of this issue of Radiologic Clinics of North America.

I am confident that this issue will guide radiologists and all other clinicians through this minefield of scientific knowledge, and it is my sincere hope that it will assist in daily practice, offering technical suggestions to optimize imaging and treatment in osteoporotic patients.