[Postmenopausal osteoporosis diagnostic methods and their indications].
The value of bone density in predicting fracture is established, and there is a general consensus that bone mineral density (BMD) measurement should be considered in patients with conditions that place them at high risk for osteoporotic fracture. However, low bone density alone is judged to be insufficient to warrant treatment. Clinical risk factors have an important role in determining who should have BMD measurement, in assessing risk of fracture, and in determining who should be treated. A history and physical examination is essential in evaluating fracture risk and should include change in posture and risk of fall. It has been suggested that the diagnosis and treatment of osteoporosis should depend on risk-bases assessment rather than only on the assessment of a T-score. From analysis of guidelines, the French Agency of Health Accreditation and Evaluation recommends BMD measurement in the following indications: radiological evidence of vertebral fracture; previous fragility fracture; previous causes of secondary osteoporosis; maternal history of hip or vertebral fracture; premature menopause (< 40 years); body mass index < 19 kg/m2; glucocorticoid therapy (> 7.5 mg/day oral prednisolone or equivalent for 3 months or more).
Jeandel
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Service de médecine interne et gériatrie, centre Antonin-Balmès, 34295 CHU de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier, France. c-jeandel@chu-montpellier.fr
D017668:Age of Onset; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D017698:Postmenopause; D017410:Practice Guidelines as Topic; D012307:Risk Factors