Osteoporosis screening of postmenopausal women in the primary care setting: A case-based approach

Background: Despite the facts that approximately half of postmenopausal women will sustain an osteoporosis-related fracture and 15% will sustain a hip fracture in their lifetime, 75% of American women between the ages of 45 and 75 years have never discussed osteoporosis with their physician. Objective: This case-based review addresses screening for osteoporosis in the primary care setting. Topics include epidemiology, assessment of fracture risk, bone mineral density testing, primary prevention of osteoporosis, and thresholds for treatment. Methods: Relevant articles were identified through a search of MEDLINE (1980-2004) using the terms osteoporosis, fractures, randomized controlled trials (RCTs), and epidemiology, pathophysiology, diagnosis, and treatment of osteoporosis. Clinical guidelines on osteoporosis were also reviewed. Conclusions: Osteoporosis is a prevalent disease in postmenopausal women. Osteoporosis-related fractures are a cause of major morbidity and mortality in older adults. Increased awareness of osteoporosis is necessary to stem the mounting number of complications.