THE CONTRIBUTION OF BONE DENSITOMETRY TO THE DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS

Objective: It has recently been proposed that a specialist osteoporosi s service, including bone densitometry, should be made available to th ose most at risk in the UK population. The aim of this study was to ev aluate such a service, and in particular the role of bone densitometry , in terms of its effect on the diagnosis of osteoporosis and clinical management of the disease. Methods: A retrospective data abstraction study was performed to investigate the diagnosis and management of pat ients referred to the Metabolic Clinic, City Hospital Nottingham, with a potential diagnosis of osteoporosis. Hospital records were availabl e for 117 patients, aged between 45 and 59, who had attended the Clini c in a given time period and undergone bone mineral density measuremen t. Results: Forty-eight patients (41.0%) had osteoporosis of the lumba r spine. The final diagnosis of osteoporosis after attending the clini c was different from that on referral in a substantial proportion (62. 6%) of cases. Only 48.9% of patients with spinal osteoporosis were ide ntified by their referring doctor. The percentage of patients receivin g treatment for osteoporosis increased from 34.2% to 72.6% after atten ding the clinic. Conclusions: Measurement of bone mineral density iden tifies cases of osteoporosis who would not otherwise be detected and a s a consequence contributes tc, the proportion of patients receiving t reatment after referral. The osteoporosis service provided by the Meta bolic Clinic including measurement of bone mineral density was thus fo und to have a considerable impact on the diagnosis and treatment of pa tients with osteoporosis.