An Open Access Bone Densitometry Service: Report of First Year's Operation

Abstract

Medical treatment of symptomatic osteoporosis is unsatisfactory. Treatment of patients with low bone density but without history of fracture includes hormone replacement therapy (HRT) which offers the prospect of reduced fracture risk. Dual energy X-ray absorptiometry (DXA) offers a safe and accurate technique available for the measurement of bone mineral density at a district general hospital level. All open access service providing densitometry measurements for general practitioners and hospital consultants was instigated at South Cleveland Hospital in February 1991. A major purpose of the service was to provide density measurements in order to 'inform' the discussion between the patient and doctor with regard to the use of anti-resorptive and other medical agents. We report our experience of operating such a service. The report analyses the main reasons for referrals. Nine hundred and thirty female subjects and 63 male subjects were scanned. The main reason for female referral were early menopause, consideration for HRT, personal history of fracture and family history of fracture--these account for 54.7% of all referrals. In men, there was a high incidence of fracture, back pain and the use of steroids given as reasons for referral. Sixty-seven per cent of patients were referred by general practitioners. Eighteen per cent of female lumbar spinal BMD values were between 1 and 2 S.D. below the Leeds normative mean and 9.0% below 2 S.D. Figures for the femoral neck were 22.0 and 9.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

An analysis of an open access general practitioner bone densitometry service

“…The major indications for DXA referral in our service were family history of osteoporosis or fracture, previous fractures and X-ray appearance of osteopenia. A previous report of the open access DXA service in South Tees Health District in 1991 by Fordham et al (22) showed that the main reasons for DXA referral were early menopause and patients deciding on hormone replacement therapy. This difference might be due to the availability of other treatments (such as etidronate licensed in 1992 and alendronate licensed in 1995 in the UK) and the GPs' greater awareness of other risk factors of osteoporosis.…”

Forearm Bone Mineral Density of Normal Indian Population

“…Various methods are available for measuring bone density like DEXA, Dual-photon absorptiometry (DPA) [11] [12], Quantitative ultrasound (QUS) [13] and Computed tomography (CT) [14] [15]. DEXA is currently considered the bone densitometric technique of choice [1] [2]. DEXA is found to have a low radiation exposure (less than 0.1 microGy) [16].…”

Use of Bone Densitometry by Ontario Family Physicians

“…There is limited additional information on densitometry use from reviews of referral patterns to densitometry facilities. Data from a 1991 British study [15] and the 1996 U.S. randomized trial of bone density reporting [11] both identified risk factors for osteoporosis (including early menopause, family history of osteoporosis, medical conditions and steroid use) as the most common indication for densitometry. Other reasons were consideration of HRT, history of fracture, patient request and back pain.…”