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Combined treatment of post-menopausal osteoporosis: effect on muscle function and a new radiological method for assessing trabecular bone.

Ten women presenting with at least two osteoporotic vertebral crush fractures were treated with alfacalcidol (one-alpha-hydroxycholecalciferol), calcium lactogluconate, oestrogen and progestagen for 6 months. Significant improvements in the patient's assessment of pain, grip strength, walking and stair climbing times were found. These suggest that a sub-clinical myopathy may be a feature of osteoporosis. The role of combination treatment is discussed in depth. Radiographs of the thoracic and lumbar spines revealed no further deterioration and there was no significant reduction in standing height. Microfocal radiographs of the hand showed no change in metacarpal cortical bone width. This novel technique allowed a qualitative assessment of trabecular bone in the distal metacarpal but no consistent effect of treatment was observed.