Whom to ScreenMary Laya, MD, MPH & Laurel Desnick, MD Literature reviewed April 26, 2011
A 65-year-old woman presents for a preventive health exam. She has hypertension and takes lisinopril as her only medication. She does not drink alcohol or smoke. She exercises three times weekly, and rates her overall health as excellent. She has never had a fracture or used corticosteroids. There is a family history of diabetes in both parents but otherwise it is unremarkable.
Click an answer under each question.
Does she need screening for osteoporosis?
With further questioning, the woman says she has already had osteoporosis screening at her church health fair. They checked her bone density at the wrist and told her she had osteoporosis. Are you ready to prescribe treatment?
- Option A Yes. The test she had is reliable and she should begin treatment.
- Option B No. The test she had is called a pDXA and it may be helpful in predicting decreased bone density. She should have a confirmatory test with a DEXA of the central skeleton before treatment is considered.
- Option C No. The test she had is called a pDXA and is not at all accurate for predicting fracture.
If her hip DXA did not show osteoporosis, when would you screen her again?
Is screening for osteoporosis recommended for older men without risk factors?