Book Review

Osteoporosis

N Engl J Med 1996; 335:1616-1617November 21, 1996

Article

Osteoporosis
Edited by Robert Marcus, David Feldman, and Jennifer Kelsey. 1373 pp., illustrated. San Diego, Calif., Academic Press, 1996. $149.95. ISBN: 0-12-470860-9

Interest in osteoporosis has grown exponentially in the past two decades, with the diversification of research well beyond traditional areas into such fields as engineering and epidemiology. A small number of excellent journals and textbooks on various aspects of osteoporosis are already available, but a textbook focused solely on this condition and encompassing this diversity of research has been lacking. This book does a terrific job of filling the gap. It contains 70 chapters grouped in 6 sections, which cover skeletal biology, structure and biomechanics, epidemiology and risk factors, pathophysiology, evaluation and management, and pharmacology and therapeutics. All the chapters are authoritative and include up-to-date references. The book is augmented by a companion slide set featuring 120 of the figures from various chapters.

Osteoporosis is quite comprehensive; indeed, topics that typically receive brief treatment elsewhere (osteoporosis in minority groups and in men) receive entire chapters here. Among my favorite chapters are those that provide a conceptual overview of a topic, such as the chapters on bone remodeling, nutrition, and the nature of osteoporosis. The book also covers relevant methodologic concepts, no doubt reflecting the editors' desire to make the material accessible to readers with other primary research interests. For example, the sections on epidemiology and pharmacology begin with chapters on methodology that include discussions of the strengths and weaknesses of various study designs. Subsequent chapters build on these discussions by reviewing data according to the type of study, thus making it easier to evaluate the strength of the data. The chapters on evaluation and management are practical in orientation, often giving detailed information on how and when to perform tests and how to interpret the results.

To cover osteoporosis in breadth and depth, the editors enlisted 132 authors; it is therefore not surprising that some topics are covered more than once. I view this overlap as a strength of the book, because it often provides different perspectives on a topic. In some cases, however, the reader must synthesize the information from several chapters to benefit from this overlap. Some topics are covered in unexpected parts of the book. For example, the excellent chapter on assessing the risk of fracture, which is in the section on epidemiology and risk factors, addresses important clinical questions, such as who should undergo bone-density measurements, at which skeletal sites, and how often. The text includes many cross-references to other pertinent chapters, but diligent readers will want to scan the outline at the beginning of each chapter or the index to be certain that all the relevant material has been located. Those who do so will be rewarded with a better understanding of the issue than that gained by reading only one discussion.

The editors have succeeded in assembling a textbook devoted to osteoporosis that is comprehensive and addresses a broad range of research interests.

Anne C. Looker, Ph.D.
National Center for Health Statistics, Hyattsville, MD 20782