Bone densitometry: relevance to health care

Since low bone density is a risk for fracture, the relevance of bone densitometry as a basis for health care assessment needs to be elucidated. Most patients with fractures are in the lower two quartiles of bone density. Bone densitometry can be used to provide a quantitative estimate of fracture risk and a measurable response to aging, disease or medical treatment in the individual. Some difficulties concerning the efficacy of screening the whole population are discussed, for instance in terms of the success of treatment. Screening to prevent fractures should be advocated in women considering HRT. Research into defining bone quality is needed, as are further studies on the pathogensis of low bone density and on the contributions of low peak bone density and rates of loss to bone density in adults.