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Bone mineral density (BMD) measurements have been the gold standard for diagnosing osteoporosis for the last 20 years. Doctors and patients have relied on dual-energy X-ray absorptiometry(DEXA or DXA). DXA is a type of X-ray imaging used to measure BMD and make the diagnosis.
However, studies show that using DXA as the only measure may not be enough. Current research suggests a change. Risk factors combined with DXA results are a better way to evaluate each person. And where DXA is not available in this country (or in other less developed countries), clinical risk factors may be enough to predict fractures.
Age and a past history of fracture(s) are the two most important predictive factors. The risk of low bone mass called osteopenia and the risk of osteoporosis go up with increased age. Other risk factors include current or past use of corticosteroids, current cigarette smoking, and family history of fracture.
Drinking more than two units of alcohol is another risk factor. One unit is equal to one 12 oz. beer, one five oz. glass of wine, or 1.5 oz. of hard liquor.
The older the individual and the more the risk factors, the greater the chances for bone fracture. Without the use of DXA, treatment is advised based on age, history, and physical examination. Even with DXA, there are many older adults with osteopenia who sustain a bone fracture. This fact suggests earlier treatment of low bone mass is needed in some people.
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