Osteoporosis screening of postmenopausal women in the primary care setting: a case-based approach.
BACKGROUND
Despite the facts that approximately half of postmenopausal women will sustain an osteoporosis-related fracture and 15% will sustain a hip fracture in their lifetime, 75% of American women between the ages of 45 and 75 years have never discussed osteoporosis with their physician.


OBJECTIVE
This case-based review addresses screening for osteoporosis in the primary care setting. Topics include epidemiology, assessment of fracture risk, bone mineral density testing, primary prevention of osteoporosis, and thresholds for treatment.


METHODS
Relevant articles were identified through a search of MEDLINE (1980-2004) using the terms osteoporosis, fractures, randomized controlled trials (RCTs), and epidemiology, pathophysiology, diagnosis, and treatment of osteoporosis. Clinical guidelines on osteoporosis were also reviewed.


CONCLUSIONS
Osteoporosis is a prevalent disease in postmenopausal women. Osteoporosis-related fractures are a cause of major morbidity and mortality in older adults. Increased awareness of osteoporosis is necessary to stem the mounting number of complications.
Edwards
Beatrice J
BJ
Bone Health and Osteoporosis Program, Division of Geriatric Medicine, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. BJE168@northwestern.edu
Brooks
Ellen R
ER
Langman
Craig B
CB
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D011322:Primary Prevention; D018570:Risk Assessment