[Differential diagnosis in osteoporosis]. / Differentialdiagnose der Osteoporose.

Osteoporosis is a so called metabolic osteopathy. Under this term alterations are included concerning primary the bone tissue, but in consequence disable bone organs. Into this group of affections belong also the osteomalacia, the parathyreogenic osteodystrophy, the osteosclerosis caused by systemic changes of the bone tissue turn-over and furthermore different combinations of such alterations. For their principal diagnosis in every single case the histological findings are most important for their pathogenetic differentiation and for the (therapeutically and diagnostically important) individual specification anamnesis, X-ray findings and several biochemical parameters are important.

[What is appropriate in postmenopausal osteoporosis?]. / Was ist richtig an der postmenopausischen Osteoporose?

The term of postmenopausal osteoporosis created 1940/1941 by Albright and his coworkers corresponds on our days no more to the original conception, because it is used now in a broader form. The resulting practical consequences, e.g. the postulates of a general medical prophylaxis, induce a new discussion which is adapted to the scientific state of to-day and the real importance.

[Was Beethoven's deafness caused by Paget's disease? Report of findings and study of skull fragments of Ludwig van Beethoven]. / Ertaubte Beethoven an einer Pagetschen Krankheit? Bericht über die Auffindung und Untersuchung von Schädelfragmenten Ludwig van Beethovens.

Paget's disease of bone (osteitis deformans) has been repeatedly named as a possible cause for Ludwig van Beethoven's deafness. In 1985 a descendent of Franz Romeo Seligmann (a Viennese medical historian who in 1863 had studied Beethoven's mortal remains on the occasion of their relocation) presented to us three bone fragments allegedly from Beethoven's cranium. They represented fragments of the left parietal bone and the occiputum. It was possible to prove nearly with certainty that these bone fragments actually are Beethoven's. They did not show signs of Paget's disease of bone. It must therefore be concluded that Beethoven's deafness was not caused by Paget's osteitis deformans.

[Terminology of osteopenic skeletal changes]. / Zur Terminologie osteopenischer Skelettveränderungen.

Osteology which was for a long time only sporadically be found in the literature of internal medicine won an increasing importance during the last decades, above all as the problems of so-called metabolic osteopathy are concerned. Sometimes technical terms appeared which were incorrectly chosen or used, which at any case led to certain misunderstandings. The consequences of this concern partly essential questions of pathology and therapy. In the present discussion it is tried to correct several of these notions and to formulate them according to the actual facts.

[Advances in the treatment of osteoporosis (author's transl)]. / Fortschritte in der Behandlung der Osteoporose.

Osteoporosis is not a disease in itself and, hence, the management and prognosis in any individual case depends on the aetiology. Other important factors determining treatment are the extent of the osteoporotic changes, the age and sex of the patient, the severity of the symptoms and the complications. The paramount aim of therapy is to arrest the osteoporotic process by selective treatment of the underlying cause of bone rarefication and, if possible, to achieve compensatory strengthening of the remaining skeletal structure by stimulating the formation of new bone.

[Bone scintigraphy in osteodystrophia deformans (Paget's disease)]. / Knochenszintigraphie bei Osteodystrophia deformans (M. Paget).

The value of combined investigations using both scintiscanning and radiological procedures has been proved for the disease's extension and activity in 28 patients suffering from osteodystrophia deformans (Pagets disease). It was seen that such a method leads to more precise results concerning the patient's condition. Special therapy indications were set up, based on these summarized findings. A further advantage of bones scanning alone is the lower radiation dose, which is mainly indicated for control tests in Paget's course. At present, we have no experience of malignant forms of this disease among our group of patients.

[Principles in the therapy of osteoporosis. 2. Therapy]. / Prinzipien der Osteoporose-Therapie. 2. Therapie

"Osteoporosis" is no disease by itself, but solely an anatomically equal result of various etiologic and pathogenetic influences on the bone structure or parts of same. A therapeutic effect and prognosis are dependent on these conditions to a considerable extent. Practically, it is therefore of paramount importance to distinguish between various clinical pictures of osteoporosis as well as to separate them from hypostotic changes of the skeleton. No more than a single type of "osteoporosis" exists, a uniform treatment can be applied. Cause and extent of the change, age and sex of the afflicted, individual complaints and complications determine the therapeutic procedure in every case. Jointly, all efforts tend to stop the decrease of the bone tissue inherent in the porosity, and to achieve, whenever possible, a compensatory increase of the bone structure still remaining by stimulation of the osteopoiesis.

[Principles of the therapy of osteoporosis. 1. Definition, classification, diagnosis]. / Prinzipien der Osteoporose-Therapie. 1. Definition, Einteilung, Diagnose

More and more the treatment of osteoporotic changes of the skeleton becomes a topic of discussion of an emotional nature. Whatever reasons may exist, it can be taken for granted that a considerable interest can be found in the pertinent problems coming up, and that a difference of opinion exist on some issues. However, certain principles should not be disputed, since nowadays there is hardly any doubt as to their validity. To represent these and to compare them with the methods of treatment of an osteoporosis discussed today is the purpose of this information. This first part contains definition, classification and diagnosis.

[Diagnostic procedure in osteodystrophia deformans Paget]. / Diagnostisches Vorgehen bei Osteodystrophia deformans Paget.

Simultaneous scintigraphic and X-ray examination has been evaluated in 30 patients with Paget's disease for estimation of extension and activity of the disease. Scintigraphy produces a comprehensive picture of the pathophysiologic condition. When compared with X-rays the procedure is more economic with regards to cost, time and radiation dosage. Therefore, the use of radioisotopes for evaluation of the skeleton is strongly recommended for follow-up examination in Paget's disease.