Question

63 yr old women presents in office for annual inquires about the need for bone density screening, experience a broken forearm as a child, BMI of 27, non smoker, 6oz of wine 2-3 times a week. you advise her:

1. Z score of greater than or equal to 1 at spine or hip on BMD is Dx for osteoporosis

2. women less than 65 should be screened for osteoporosis of estimated 5 yr fracture risk equals or exceeds that of 65 yr old white female with no risk facotr

3. USPSTF recommend screening for osteoporosis with bone mesurement testing to prevention fracture in women 65yr or older

4 offer annual dexa screening starting age 65yr

Answer 1

2, Women less than 65 should be screened for osteoporosis of estimated 5yr fracture risk equals or exceeds that of 65 yr old white female with no risk factor.
Z score helpful to diagnose secondary osteoporosis used for children, young adults, women who are premenopausal and men under 50 years.
Dexa bone density score can be a mistake and not a perfect predictor for bone health or fracture risk.
High-risk factors of osteoporosis include advancing age, being female whether Asian or white race
USPSTF found evidence by bone measurement test that clinical risk assessment tools are moderately accurate.