Quantitative ultrasound and risk factor enquiry as predictors of postmenopausal osteoporosis: comparative study in primary care

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Abstract
Introduction The current recommendation for primary care physicians to identify women at high risk of osteoporosis relies on the assessment of clinical risk factors as a selection method for referral for dual energy x ray absorptiometry (DXA).1 DXA remains the “gold standard” diagnostic investigation for osteoporosis, but the restrictions of cost and availability necessitate an effective selection process. Little evidence exists about the value of enquiring about risk factors in primary care as a selection method, but it has been reported to be a poor predictor of low bone mass.2 Quantitative ultrasound scanning can be used to predict risk of osteoporotic fracture.3 Preliminary findings indicate that ultrasound scanning is as good as clinical risk factors for prediction of osteoporosis, but its role in primary care has yet to be clarified.4 We compared these selection methods in postmenopausal women in a primary care setting.