Osteoporosis, a disease characterized by low bone strength and fractures that occur with very low-impact loads, has experienced many changes over the past 20 years and we should expect to see many more in the future. Prior to 1990, there was little activity in the field: although there were some small studies with sodium flour-ide, they set the field back because these compounds improved bone mass but increased bone fragility and fractures. While osteoporosis, or bone fragility, was generally accepted to be part of the normal process of ageing in post-menopausal women, an osteoporotic fracture diagnosed the disease, unfortunately at a very advanced stage. Until the development of DPA followed by dual-energy X-ray absorptiometry (DEXA), there was no method to determine an individual's risk of an osteoporotic fracture before the event. However, in 1992, T-scores (s.d.'s above and below peak bone mass) became a way to identify individuals who would, over time, be at increased risk of osteoporotic fractures [1].
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