title: Osteoporosis risk factor assessment increases the appropriate use of dual energy X-ray absorptiometry in men and reduces ethnic disparity.
abstract: BACKGROUND
  Male patients are frequently not tested for osteoporosis even in the presence of recognized risk factors for that disease.
  
  
  OBJECTIVE
  To evaluate if the assessment of risk factors for osteoporosis increases the utility of dual energy X-ray absorptiometry (DXA) in men over the age of 50 attending a rheumatology clinic.
  
  
  METHODS
  Men over 50 attending a rheumatology clinic completed a checklist of 10 risk factors for osteoporosis before seeing the physician. The physician reviewed the checklist and made a management decision. The checklists and medical records were reviewed for medical history and DXA results. Comparisons were made with DXA requests before the use of the checklist.
  
  
  RESULTS
  Medical records of 183 men were reviewed, including 111 African Americans (AA) and 67 whites. Twenty-three percent of patients had rheumatoid arthritis (14% of AA, 37% of whites) and 27% of patients were on glucococorticoids. Before the use of the checklist, 14% of men had a DXA (6% of AA and 29% of whites) compared with 29% of patients (21% for AA and 42% for whites) after the checklist was instituted in the clinic. Sixty-three percent of AA with rheumatoid arthritis had DXA compared with 65% of whites. Thirteen patients had osteoporosis whereas 16 had osteopenia.
  
  
  CONCLUSIONS
  The use of a check list of risk factors for osteoporosis may increase the appropriate use of DXA in male patients over the age of 50 at risk for osteoporosis.
authors.affiliation: Rheumatology Section 151 K, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA. john.richards@med.va.gov
authors.forename: J Steuart
authors.initials: JS
authors.lastname: Richards
authors.forename: Richard L
authors.initials: RL
authors.lastname: Amdur
authors.forename: Gail S
authors.initials: GS
authors.lastname: Kerr
mesh_terms: D015502:Absorptiometry, Photon; D001741:Black or African American; D000368:Aged; D015519:Bone Density; D002983:Clinical Competence; D019091:Critical Pathways; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000208:ethnology; D010044:Outpatient Clinics, Hospital; D010820:Physicians; D012216:Rheumatic Diseases / Q000150:complications / Q000188:drug therapy; D013256:Steroids / Q000009:adverse effects; D044465:White People
chemical_list: D013256:Steroids