title: The contribution of bone densitometry to the diagnosis and treatment of osteoporosis.
abstract: OBJECTIVE
  It has recently been proposed that a specialist osteoporosis service, including bone densitometry, should be made available to those most at risk in the UK population. The aim of this study was to evaluate such a service, and in particular the role of bone densitometry, in terms of its effect on the diagnosis of osteoporosis and clinical management of the disease.
  
  
  METHODS
  A retrospective data abstraction study was performed to investigate the diagnosis and management of patients referred to the Metabolic Clinic, City Hospital Nottingham, with a potential diagnosis of osteoporosis. Hospital records were available for 117 patients, aged between 45 and 59, who had attended the Clinic in a given time period and undergone bone mineral density measurement.
  
  
  RESULTS
  Forty-eight patients (41.0%) had osteoporosis of the lumbar spine. The final diagnosis of osteoporosis after attending the clinic was different from that on referral in a substantial proportion (62.6%) of cases. Only 48.9% of patients with spinal osteoporosis were identified by their referring doctor. The percentage of patients receiving treatment for osteoporosis increased from 34.2% to 72.6% after attending the clinic.
  
  
  CONCLUSIONS
  Measurement of bone mineral density identifies cases of osteoporosis who would not otherwise be detected and as a consequence contributes to the proportion of patients receiving treatment after referral. The osteoporosis service provided by the Metabolic Clinic including measurement of bone mineral density was thus found to have a considerable impact on the diagnosis and treatment of patients with osteoporosis.
authors.affiliation: Department of Public Health Medicine and Epidemiology, University of Nottingham Medical School.
authors.forename: C A
authors.initials: CA
authors.lastname: Coupland
authors.forename: I
authors.initials: I
authors.lastname: Packham
authors.forename: A R
authors.initials: AR
authors.lastname: Lyons
authors.forename: C E
authors.initials: CE
authors.lastname: Chilvers
authors.forename: D J
authors.initials: DJ
authors.lastname: Hosking
mesh_terms: D015502:Absorptiometry, Photon / Q000592:standards*; D015519:Bone Density; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000628:therapy; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D015397:Program Evaluation; D011877:Radionuclide Imaging; D012017:Referral and Consultation; D012189:Retrospective Studies