Preventing osteoporosis: current practices and problems.

A lateral x-ray of the thoracic and lumbar spine should be part of the routine examination of any woman aged 40 or older. Similarly, an anteroposterior x-ray of the hand as a first assessment may suggest a need for further investigation for osteoporosis. Estrogen treatment reduces the incidence of vertebral compression and has proven protective against central as well as peripheral bone loss. However, rapid bone loss after termination of estrogen therapy implies that the protective effect may last no longer than 2 to 3 years.