title: Appropriate clinical application of bone density measurements.
abstract: When bone mass is properly evaluated as a risk factor, as opposed to a diagnostic test, its relationship to fracture risk is apparent. There is now substantial agreement among several prospective studies relating bone mass of the radius and calcaneus to fractures of the wrist, spine, hip, and other sites. Thus, selection of menopause-age women for preventive measures, including estrogen replacement, can be guided by measurements of bone mass. Although levels of bone mass can indicate the presence of fracture risk, they are insufficient measures of disease severity, and additional information is required for clinical decision making. It is possible to estimate Remaining Lifetime Fracture Probability (RLFP) based upon current bone mineral content (BMC), current age, life expectancy, and anticipated rate of bone loss. Objective estimates such as RLFP can be used to determine which patients may benefit from drug treatment of osteoporosis. The ultimate objective is to match the level and intensity of treatment to the actual level of fracture risk.
authors.affiliation: Osteoporosis Center, Kuakini Medical Center, Honolulu.
authors.forename: R D
authors.initials: RD
authors.lastname: Wasnich
authors.forename: J W
authors.initials: JW
authors.lastname: Davis
authors.forename: P D
authors.initials: PD
authors.lastname: Ross
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies