Review

DXA and clinical challenges of fracture risk assessment in primary care

Susan Williams, MS, RD, MD, CCD, FACP, FACE, Leila Khan, MD and Angelo A. Licata, MD, PhD, FACP, FACE
Cleveland Clinic Journal of Medicine November 2021, 88 (11) 615-622; DOI: https://doi.org/10.3949/ccjm.88a.20199

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ABSTRACT

Dual-energy x-ray absorptiometry (DXA) can detect bone mineral density loss before it can be identified on usual skeletal radiography, making it possible to diagnose osteoporosis in postmenopausal women and older men before clinical fractures arise. However, when DXA is used outside these populations or if the clinical picture does not match the reported T-scores, mistakes can arise in interpreting results and determining the need for pharmaceutical therapy.

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  1. 7587-susan-williamsSusan Williams, MS, RD, MD, CCD, FACP, FACE
  1. Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH
  1. 14357-leila-khanLeila Khan, MD
  1. Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH
  1. Angelo A. Licata, MD, PhD, FACP, FACE⇑
  1. Emeritus Consultant Staff, Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH
  1. Address:
    Angelo A. Licata, MD, PhD, Department of Endocrinology, Diabetes, and Metabolism, F20, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; licataa{at}ccf.org

ABSTRACT

Dual-energy x-ray absorptiometry (DXA) can detect bone mineral density loss before it can be identified on usual skeletal radiography, making it possible to diagnose osteoporosis in postmenopausal women and older men before clinical fractures arise. However, when DXA is used outside these populations or if the clinical picture does not match the reported T-scores, mistakes can arise in interpreting results and determining the need for pharmaceutical therapy.

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