title: Osteoporotic fracture risk evaluation. Options when central densitometry is not available.
abstract: BACKGROUND
  Osteoporosis-related fractures represent a major health problem. Although spine and hip bone densitometry is the gold standard to assess bone density, this test is not always accesible. The purpose of this study was to describe two options to assess the risk of fracture due to osteoporosis in post-menopausal women assigned to a primary care unit where bone densitometry is not available.
  
  
  METHODS
  A cross-sectional study was conducted in 332 post-menopausal women without diagnosis or treatment for osteoporosis, attending regularly to a primary care unit. A heel bone peripheral densitometry, physical exam and medical history were performed. The assessment of fracture risk was carried out using the FRAX™ method.
  
  
  RESULTS
  Mean age was 60 ± 8.7 years and body mass index was 28.68 ± 4.24. According to the heel bone peripheral densitometry, 19 (5.7 %) women had osteoporosis (T-score less than or equal to -2.5), 171 (51.8 %) had osteopenia (T-score between -2.5 and less than or equal to -1) and 141 (42.5 %) had normal bone mineral density. According to the FRAX method, 13 (3.9 %) had an increased risk of osteoporotic fracture in a 10-year period and 40 (12 %) of hip fracture.
  
  
  CONCLUSIONS
  There was low concordance in the 10-year risk for major osteoporotic fracture and hip fracture assessed with both the FRAX™ and the peripheral bone densitometry methods.
authors.affiliation: Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Estado de México, México. maria.romerof@imss.gob.mx.
authors.forename: José de Jesús
authors.initials: Jde J
authors.lastname: Garduño-García
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pérez-Espejel
authors.forename: Gerardo
authors.initials: G
authors.lastname: Huitrón-Bravo
authors.forename: María del Socorro
authors.initials: Mdel S
authors.lastname: Romero-Figueroa
mesh_terms: D000368:Aged; D015519:Bone Density; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D003720:Densitometry; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis*; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control*; D010808:Physical Examination; D018570:Risk Assessment; D012307:Risk Factors
keywords: Bone density; Osteoporotic fractures; Photon absorptiometry