Update on bone density measurement

Bone densitometry is a clinically accepted technique for assessing fracture risk and evaluating skeletal change. The proper clinical use of densitometry requires an understanding of the available techniques, their appropriate application, and the potential sources of measurement error. Recent clinical guidelines recommend that all women over the age of 65 years and all postmenopausal women with risk factors should have their bone density assessed. With the advent of smaller portable devices, bone density measurements are now widely available. In particular, ultrasound techniques, which do not use radiation, have particular promise for widespread screening applications. Peripheral densitometry alone cannot adequately address all clinical questions, particularly the question of monitoring subtle changes in bone density. For this purpose, central densitometers are still preferred. For any bone density measurement to be clinically useful, it must be performed with careful attention to detail, particularly with regard to instrument calibration, patient positioning, measurement analysis, and interpretation.