title: Bone mineral density at distal forearm can identify patients with osteoporosis at spine or femoral neck.
abstract: Forearm bone mineral density (BMD) was investigated in women to identify osteoporosis at the spine or femoral neck (or both) defined by WHO criteria (T score -2.5) without requirement for fracture. BMD was measured by single-energy X-ray absorptiometry (DTX100) and by dual-energy X-ray absorptiometry (DXA) in the lumbar spine and femoral neck in 422 subjects aged 22-90 yr. A total of 62% of subjects with osteoporosis (at the spine, femoral neck, or both sites) were detected with 89% specificity [receiver operating characteristics (ROC) analysis] and included all subjects below forearm BMD 0.34 g/cm2. Conversely, above 0.419 g/cm2, only 10% of patients had osteoporosis. A total of 71.8% of women could be assigned either to those who warranted therapy (<0.34 g/cm2) or to those who did not (>0.419 g/cm2) with 90% certainty. Subjects with forearm BMD between 0.34 and 0.419 g/cm2, who constituted 28.2% of the total group and included 31% of subjects with osteoporosis, had a 40% chance of having osteoporosis. This leads to a high identification rate on subsequent DXA scanning, which is thus used efficiently.
authors.affiliation: Charles Salt Research Centre, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire.
authors.forename: T
authors.initials: T
authors.lastname: Jones
authors.forename: M W
authors.initials: MW
authors.lastname: Davie
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000473:pathology*; D005542:Forearm / Q000000981:diagnostic imaging*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity