Perspective on fracture risk and phalangeal bone mineral density.
Current bone mineral density (BMD) represents the composite, cumulative effect of many past and present risk factors, including both genetic and lifestyle influences. Reduced BMD, increasing age, and the presence of pre-existing fractures independently increase the risk of osteoporotic fracture. BMD is the most clinically useful of these indicators. Assessment of phalangeal BMD by dual-energy X-ray absorptiometry (DXA) or radiographic absorptiometry (RA) has been shown to provide long-term value in predicting the risk of both hip and spine fracture. Data from phalangeal BMD measurements may be most valuable to the patient if they are used to compute the patient's remaining lifetime fracture probability (RLFP).
Clinical Professor of Medicine, Hawaii Osteoporosis Center, Honolulu, HI 94814, USA. rdw@medsurf.com
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Wasnich