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这个女人有骨质疏松症吗?
Amanda D Green1, Cathleen S Colón-Emeric, Lori Bastian
1Ambulatory Care Service, Durham Veterans Affairs Medical Center, Durham, NC, USA.
JAMA
|December 16, 2004
概括
身体检查结果,如体重低,可以帮助识别患有骨质疏松症的风险女性,建议早期查. 特定的迹象,比如壁的距离,可能表明隐藏的脊柱骨折.
科学领域:
- 骨质疏松症查 骨质疏松症查
- 诊断的准确性 诊断的准确性
- 身体检查 身体检查
背景情况:
- 目前的指导方针建议65岁以上的女性进行骨密度计.
- 识别患有骨质疏松症和隐性脊椎骨折的年轻女性仍然是一个挑战.
研究的目的:
- 评估身体检查结果的准确性和精确性,以诊断骨质疏松症,骨质疏松症或脊柱骨折.
主要方法:
- 进行了全面的MEDLINE搜索 (1966-2004),审查了书目,查阅了教科书,并联系了专家.
- 包括使用原始数据对骨质疏松症或脊柱骨折诊断体检准确性的研究.
- 在191篇审查的文章中,有14篇在选后符合纳入标准.
主要成果:
- 没有任何单一的身体动作可以最终诊断骨质疏松症或脊柱骨折.
- 阳性概率比率 (LR+) 在以下方面是最高的:体重<51公斤 (LR+,7.3),壁壁距离>0厘米 (LR+,4.6),肋骨骨距离<2指宽 (LR+,3.8).
- 其他重要发现包括牙数量<20 (LR+,3.4) 和自我报告的背 (LR+,3.0).
结论:
- 几次体检操作,特别是低体重,可以增加不符合当前查标准的患者骨质疏松症的预测概率.
- 壁-骨距离大于0厘米,肋骨-骨盆距离小于2个手指宽,表明存在隐形脊柱骨折.
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