title: Review of 3,530 referrals for bone density measurements of spine and femur: evidence that radiographic osteopenia predicts low bone mass.
abstract: OBJECTIVE
  To determine the relationship between bone mineral density (BMD) measurements and the initial reason for referral to a BMD screening service.
  
  
  METHODS
  Referral letters for 3,479 of the 3,530 women referred for BMD screening were classified according to the indication for screening. Mean age-matched standard deviation scores (Z scores) were derived for each of the 10 most common indications. Mean BMD between each group was compared with the age-matched value from the local normal range by means of a one-sample Student t test. Mean young normal standard deviation scores (T scores) were derived, and the percentages of women with osteopenia or osteoporosis from each referral group were calculated on the basis of the World Health Organization criteria.
  
  
  RESULTS
  The most common reason for referral was to aid in a decision regarding hormone replacement therapy (n = 700). The highest proportion of women with osteoporosis in any group was in the radiographic osteopenia group (n = 269).
  
  
  CONCLUSIONS
  Radiographic evidence of osteopenia is a strong predictor of osteoporosis. Screening for osteopenia appears justified in this and other high-risk groups and those seeking a rationale for preventive therapy.
authors.affiliation: Department of Gynecology, Guy's Hospital, London, England.
authors.forename: A I
authors.initials: AI
authors.lastname: Ahmed
authors.forename: D
authors.initials: D
authors.lastname: Ilic
authors.forename: G M
authors.initials: GM
authors.lastname: Blake
authors.forename: J M
authors.initials: JM
authors.lastname: Rymer
authors.forename: I
authors.initials: I
authors.lastname: Fogelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography; D012017:Referral and Consultation; D012307:Risk Factors