Cuando vea este tema en otro idioma, podría notar algunas diferencias en la estructura del contenido, pero aún refleja las últimas orientaciones basadas en la evidencia.

Osteoporosis

View content in English
  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 15 Jul 2025
Last updated: 15 Apr 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • asintomático
Full details

Other diagnostic factors

  • dolor de espalda
  • cifosis
  • pérdida de altura
  • sensibilidad vertebral
Full details

Risk factors

  • fractura por fragilidad previa
  • sexo femenino
  • linaje de raza blanca
  • edad avanzada (>50 años en mujeres y >65 años en hombres)
  • índice de masa corporal (IMC) bajo
  • pérdida de peso
  • antecedentes familiares maternos de fractura de cadera
  • posmenopausia
  • amenorrea secundaria
  • hipogonadismo primario
  • tabaquismo
  • consumo excesivo de alcohol
  • inmovilización prolongada
  • ingesta de calcio reducida
  • deficiencia de vitamina D
  • diabetes
  • artritis reumatoide
  • sarcopenia
  • exceso de glucocorticoides
  • uso de corticosteroides
  • uso de inhibidores de la bomba de protones
  • hipertiroidismo
  • uso de heparina
  • uso de anticonvulsivos
  • tratamiento de privación de andrógenos (hombres)
  • tratamiento inhibidor de la aromatasa (mujeres)
  • uso de fármacos asociados con un mayor riesgo de caídas
Full details

Diagnostic investigations

1st investigations to order

  • exploración por radioabsorciometría de doble energía (DEXA) de la densidad mineral ósea (DMO)
Full details

Investigations to consider

  • Fracture Risk Assessment Tool (FRAX)
  • evaluación de fracturas vertebrales (DEXA-EFV)
  • puntaje óseo trabecular
  • ultrasonido cuantitativo (QUS) de calcáneo
  • radiografía (muñeca, calcáneo, columna y cadera)
  • tomografía computarizada (TC) cuantitativa
  • marcadores bioquímicos de resorción ósea y formación ósea
  • fosfatasa alcalina en suero
  • calcio sérico
  • albúmina sérica
  • creatinina sérica
  • fosfato sérico
  • 25-hidroxivitamina D sérica
  • hormona paratiroidea sérica
  • pruebas de función tiroidea
  • cortisol libre urinario
  • testosterona en suero (hombres)
  • electroforesis de proteínas en orina
  • electroforesis de proteínas séricas
Full details

Treatment algorithm

ONGOING

no inducida por glucocorticoides: mujeres

no inducida por glucocorticoides: hombres

inducida por glucocorticoides

Contributors

Authors

Khashayar Sakhaee, MD

Professor in Internal Medicine

Division Chief of Mineral Metabolism

Center for Mineral Metabolism and Clinical Research

UT Southwestern Medical Center at Dallas

Dallas

TX

Disclosures

KS declares that he has no competing interests.

Alireza Zomorodian, MD

Research Associate

Charles and Jane Pak Center for Mineral Metabolism and Clinical Research

UT Southwestern Medical Center

Dallas

TX

Disclosures

AZ declares that he has no competing interests.

Acknowledgements

Dr Khashayar Sakhaee and Dr Alireza Zomorodian would like to gratefully acknowledge Dr Alberto V Cabo-Chan Jr and Dr Lisa Leinau, the previous contributors to this topic. AVCC and LL declare that they have no competing interests.

Disclosures

AVCC declares that he has no competing interests. LL declares that she has no competing interests.

Peer reviewers

Kimberly Olson, MD

Internist

Veterans Administration Hospital

Minneapolis

MN

Disclosures

KO declares that she has no competing interests.

David Reid, MBBS

Head of Division of Applied Medicine & Professor of Rheumatology

School of Medicine & Dentistry

University of Aberdeen

Aberdeen

UK

Disclosures

DMR has attended meetings sponsored by or been paid speaker fees by Amgen, Merck, Novartis, Procter & Gamble, Roche, and Servier. He has been a paid advisor to Amgen, Merck, Novartis, Procter & Gamble, Roche, Servier, and Shire Pharmaceuticals. He has undertaken research studies funded by Amgen, Merck, Novartis, Procter & Gamble, and Roche.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

ACOG Committee on Clinical Practice Guidelines–Gynecology. Osteoporosis prevention, screening, and diagnosis: ACOG clinical practice guideline no. 1. Obstet Gynecol. 2021 Sep 1;138(3):494-506. Abstract

LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022 Oct;33(10):2049-102.Full text  Abstract

ACOG Committee on Clinical Practice Guidelines–Gynecology. Management of postmenopausal osteoporosis: ACOG clinical practice guideline no. 2. Obstet Gynecol. 2022 Apr 1;139(4):698-717. Abstract

Humphrey MB, Russell L, Danila MI, et al. 2022 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Rheumatol. 2023 Dec;75(12):2088-102.Full text  Abstract

Eastell R, Rosen CJ, Black DM, et al. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society* clinical practice guideline. J Clin Endocrinol Metab. 2019 May 1;104(5):1595-622.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Osteoporosis images

  • Differentials

    • Mieloma múltiple
    • Osteomalacia
    • Enfermedad renal crónica-trastorno mineral y óseo
    More Differentials

  • Guidelines

    • Screening for osteoporosis to prevent fractures
    • Evidence-based guideline for the management of osteoporosis in men
    More Guidelines

  • Patient information

    Osteoporosis: preguntas para formularle al médico

    Dolor de talón (fascitis plantar)

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer