Clinical Use of Bone Densitometry
Top Cited Papers
- 16 October 2002
- journal article
- review article
- Published by American Medical Association (AMA) in JAMA
- Vol. 288 (15), 1889-1897
- https://doi.org/10.1001/jama.288.15.1889
Abstract
Review from JAMA — Clinical Use of Bone Densitometry — Scientific Review — ContextOsteoporosis causes substantial morbidity and costs $13.8 billion annually in the United States. Measurement of bone mass by densitometry is a primary part of diagnosing osteoporosis and deciding a preventive treatment course. Bone mineral densitometry has become more widely available and commonly used in practice.ObjectiveTo review evidence about the value of various clinical applications of bone densitometry.Data SourcesA MEDLINE search was performed to update previous meta-analyses of the relationship between various measurements of bone density and risk of vertebral and hip fracture. We used data from the prospective Study of Osteoporotic Fractures to estimate risk of fracture from bone density and age in postmenopausal women.Study Selection and Data ExtractionWhen available, meta-analyses and systematic reviews are emphasized in the review.Data SynthesisBone mineral density (BMD) predicts fracture and can be used in combination with age to estimate absolute risk of fractures in postmenopausal white women. Hip BMD predicts hip fracture more strongly than other measurements of BMD. There are insufficient data to translate BMD results into risk of fracture for men and nonwhite women. The benefits of treatments to prevent fractures depend on BMD: women with osteoporosis have a greater risk of fractures and greater benefit from treatments than women without osteoporosis.ConclusionsGuidelines based on systematic reviews and a cost-effectiveness analysis have suggested that it is worthwhile to measure BMD in white women older than 65 years and perhaps to use risk factors to select younger postmenopausal women for densitometry. Other potential clinical applications of BMD that have not yet been adequately studied include screening men or nonwhite women, monitoring BMD in patients receiving treatment, and using BMD to identify patients who should be evaluated for secondary causes of osteoporosis.Keywords
This publication has 43 references indexed in Scilit:
- The Association of Radiographically Detected Vertebral Fractures with Back Pain and Function: A Prospective StudyAnnals of Internal Medicine, 1998
- Prevalence of Low Femoral Bone Density in Older U.S. Adults from NHANES IIIJournal of Bone and Mineral Research, 1997
- Volumetric quantitative computed tomography of the proximal femur: Precision and relation to bone strengthBone, 1997
- Medical Expenditures for the Treatment of Osteoporotic Fractures in the United States in 1995: Report from the National Osteoporosis FoundationJournal of Bone and Mineral Research, 1997
- Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fracturesBMJ, 1996
- Age-related reductions in the strength of the femur tested in a fall-loading configuration.The Journal of Bone & Joint Surgery, 1995
- Bone mineral density and mass in a cross-sectional study of white and asian womenJournal of Bone and Mineral Research, 1993
- Bone density at various sites for prediction of hip fracturesThe Lancet, 1993
- Incidence of clinically diagnosed vertebral fractures: A population-based study in rochester, minnesota, 1985-1989Journal of Bone and Mineral Research, 1992
- Bone mineral density and mass by total-body dual-photon absorptiometry in normal white and asian menJournal of Bone and Mineral Research, 1991