OVERVIEW OF THE CLINICAL USEFULNESS OF BONE-MINERAL MEASUREMENTS IN THE PREVENTION OF POSTMENOPAUSAL OSTEOPOROSIS

Bone mass measurements might be useful in two ways in prevention of po stmenopausal osteoporosis: the decision to start HRT, or other therapy , could be based on such measurements; and, possibly, compliance to tr eatment would be enhanced. Bone density measurement appears to have su fficient predictive value for osteoporotic fracture, especially when d ensity is measured by dual-energy X-ray absorptiometry. However, choic e of skeletal site for the measurement cannot be made with certainty, although a vertebral site may be best early in menopause; and in women with osteophytes or scoliosis, and with older women, the femur or wri st may be preferred. With respect to enhancement of patients' complian ce to HRT, as well as clinicians' willingness to prescribe treatment, it has not yet been clearly shown that bone mass measurements have a s ignificant effect. This topic involves economic efficiency and should be evaluated by considerations of economics weighed against medical ef ficacy.