Bone failure or osteoporosis: what’s in a name?

Chris White, John Eisman



In clinical practice we know when an organ system is not working properly and we call it by its appropriate name: organ failure. The term is straightforward and treatment follows accordingly. A similar approach is needed in the way we approach osteoporosis. By introducing the term ‘bone failure’ and distinguishing between osteoporosis as a risk factor and bone failure as a disease, we set the stage for better clinical management.

Key Points

  • The way we name something defines the way we think about it and prioritise our investigations and treatment.
  • Osteoporosis is used to describe both a disease and a risk factor, which causes confusion. Low bone density defines osteoporosis but it is also a risk factor for osteoporotic fracture.
  • When ‘osteoporosis the disease’ becomes ‘bone failure’ we gain the ability to distinguish between the risk factor and the disease.
  • Bone failure is an accurate term for the clinical condition where a bone fractures, either spontaneously or under circumstances when we would not expect it to do so.
  • Recognising the first bone failure event is key and secondary fracture prevention is crucial as we live longer lives.

    Picture credit: © Brian Evans/Science Source/