Assessment of fracture risk.
The diagnosis of osteoporosis is based on the measurement of bone mineral density (BMD). There are a number of clinical risk factors that provide information on fracture risk over and above that given by BMD. The assessment of fracture risk thus needs to be distinguished from diagnosis to take account of the independent value of the clinical risk factors. These include age, a prior fragility fracture, a parental history of hip fracture, smoking, use of systemic corticosteroids, excess alcohol intake and rheumatoid arthritis. The independent contribution of these risk factors can be integrated by the calculation of fracture probability with or without the use of BMD. Treatment can then be offered to those identified to have a fracture probability greater than an intervention threshold.
Kanis
John A
JA
Centre for Metabolic Bone Diseases (WHO Collaborating Centre), University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.pontefract@sheffield.ac.uk
Borgstrom
Frederik
F
De Laet
Chris
C
Johansson
Helena
H
Johnell
Olof
O
Jonsson
Bengt
B
Oden
Anders
A
Zethraeus
Niklas
N
Pfleger
Bruce
B
Khaltaev
Nikolai
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000235:genetics; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D012008:Recurrence; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects
D005938:Glucocorticoids