Article Text

  1. H. M. Coplin1,
  2. K. B. Feiereisel2,
  3. H. Diaz3
  1. 11Hennepin County Medical Center, Minneapolis, MN
  2. 2Wake Forest University, Winston-Salem, NC
  3. 3Michael Reese Hospital, Chicago, IL


Background Osteoporosis can cause devastating fractures, compromise quality of life, and lead to premature death. Screening rates remain low despite Medicare coverage of dual x-ray absorptiometry (DEXA) scans for women over age 65 or women with risk factors for developing osteoporosis. Previous studies have shown that radiographic evidence of osteopenia is a strong predictor of osteoporosis. Its presence should influence rates of osteoporosis screening.

Methods This is a multicenter cohort prospective quality improvement study of patients presenting for care at resident and attending outpatient clinics affiliated with 13 US medical centers. Women age 65 or older with at least one prior visit to the clinic in the last 2 years were enrolled. Their charts were reviewed at the date of enrolment for records of previously obtained radiographs and results of DEXA scans if completed.

Results Preliminary results are available for 118 women from six of the early reporting sites. Descriptive analysis reveals that 18 women had radiographic evidence of osteopenia. Seven women (38.9%) with radiographic osteopenia had been referred for a DEXA scan compared with a 44% osteoporosis screening rate of women without radiographic evidence (p = .69). Of the seven women with radiographic osteopenia referred for DEXA scan, two (29%) had t-scores consistent with osteoporosis and three (43%) had t-scores of osteopenia.

Conclusion Our preliminary data show that the majority of women with radiographic osteopenia did not have further evaluation by DEXA scan to evaluate for osteoporosis. The presence of osteopenia by radiography did not influence the rate of osteoporosis screening. Yet when these women did undergo evaluation with DEXA, 72% had findings consistent with either osteopenia or osteoporosis. Although our numbers are small, radiographic osteopenia was confirmed as an indication for DEXA scan to evaluate for osteoporosis. Clinical systems should be developed to trigger formal osteoporosis screening when any radiologic study suggests osteopenia in women.

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