From Brittle Bones to Standard Deviations: The Historical Development of Osteoporosis in the Late Twentieth Century

Abstract

At the dawn of the twenty-first century, osteoporosis is described as a major public health problem of pandemic proportions, affecting millions of people, and women in particular, around the globe. This situation is frequently described as a result of an aging population, but it is also a consequence of a substantial transformation of the medical understanding and definition of osteoporosis in the latter half of the twentieth century. In this article, the authors trace the transformation of a biologically based understanding of the condition involving a few patients, to the current statistically based definition of osteoporosis from which only a few remain untouched. At the center of this development is the measurement of bone mineral density through densitometrics, combining the use of imaging techniques and statistical epidemiology.