Prediction of fracture risk. I: Bone density

The American Journal of the Medical Sciences
P D Miller, M McClung

Abstract

Low bone mass is the most important and individually objective predictor of osteoporotic fragility fracture risk. The challenge to the clinicians who care for patients with low bone mass is to identify those who are asymptomatic and nonfractured by using a bone mass measurement technique to make a diagnosis and decide on the level of intervention. All bone mass measurement techniques have value and limitations, necessitating careful individual clinical interpretation to avoid a misdiagnosis of osteoporosis or an erroneous interpretation of serial changes in bone mass. The inverse relationship between low bone mass and increasing fracture risk needs to be carefully interpreted because this relationship has only been determined in patients with a mean age of 65 years. It is not the same in younger, perimenopausal patients. Increasing age is a strong, independent risk factor for fragility fracture. In patients older than 70 years the curves relating fracture risk to low bone mass density become exponential when more than 3.0 standard deviations below peak adult bone mass. The assessment of this relationship is a professional activity and needs clinical input from appropriately educated physicians.

References

Jun 1, 1991·Annals of Internal Medicine·P D RossR D Wasnich
Jun 1, 1996·Calcified Tissue International·S L GreenspanE Myers

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Citations

Jun 22, 2000·American Journal of Physical Anthropology·S Mays
Nov 14, 2001·The Journal of Trauma·E OlschewskiJ N Powell
Aug 12, 2004·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·P D MillerE S Siris
Nov 5, 1999·Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry·P D MillerN B Watts
Apr 26, 2008·Journal of Biomedical Materials Research. Part a·Jeffry S NymanXiaodu Wang
Oct 4, 2007·Journal of the American Geriatrics Society·Jennifer Grossman, Catherine H MacLean
Nov 25, 2011·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Tara CusickLe T Duong
Aug 15, 2003·Clinics in Geriatric Medicine·Paul D Miller
Apr 18, 2003·Endocrinology and Metabolism Clinics of North America·Paul D Miller
Jul 1, 1997·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·P D Miller

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