Summary
Normally, strong muscles make strong load-bearing bones, and persistently weak muscles
make weak ones. We now have a general understanding of how and why that happens. Unexpectedly
that understanding also affects our understanding of the nature, pathogenesis and
study of disorders currently classified as “osteopaenias” and “osteoporoses”. Such
things promise to change how we view, study and manage those disorders. At present,
those things incite discussions among authorities that in time should lead to a new
accepted “wisdom” about those disorders. Many clinicians who manage patients on a
daily basis would probably like to know what issues that process concerns. Because
of the importance of those issues to so many millions of this planet's present and
future six billion souls, and because of their bearing on the related research, one
could argue that clinicians and researchers are entitled to know about those issues.
For that reason this article summarizes some of them, of course as I seem them.
It is understood that other times, places and people would resolve any questions about
those issues, and that any new accepted wisdom that depends upon their resolution
should lie in the future.
Recent recognition of the effects of muscle and biomechanics on the biologic ‘‘machinery”
that determines whole-bone strength and bone health incite many changes in formerly
accepted views about the nature, diagnosis, pathogenesis, study and management of
the group of different disorders that are currently considered as falling under the
umbrellas of “osteoporosis” and “osteopaenia”. This article acquaints interested physicians
with some of those changes and the reasons for them. It should take time, probably
several years, for those changes to gel into an accepted new standard of care for
such disorders. Meanwhile currently accepted standards of care could and probably
should be followed.
Keywords Treatment - absorptiometry - biomechanics - diagnosis
