Osteoporosis risk factor assessment increases the appropriate use of dual energy X-ray absorptiometry in men and reduces ethnic disparity

J Clin Rheumatol. 2008 Feb;14(1):1-5. doi: 10.1097/RHU.0b013e31816356be.

Abstract

Background: Male patients are frequently not tested for osteoporosis even in the presence of recognized risk factors for that disease.

Objectives: To evaluate if the assessment of risk factors for osteoporosis increases the utility of dual energy X-ray absorptiometry (DXA) in men over the age of 50 attending a rheumatology clinic.

Methods: Men over 50 attending a rheumatology clinic completed a checklist of 10 risk factors for osteoporosis before seeing the physician. The physician reviewed the checklist and made a management decision. The checklists and medical records were reviewed for medical history and DXA results. Comparisons were made with DXA requests before the use of the checklist.

Results: Medical records of 183 men were reviewed, including 111 African Americans (AA) and 67 whites. Twenty-three percent of patients had rheumatoid arthritis (14% of AA, 37% of whites) and 27% of patients were on glucococorticoids. Before the use of the checklist, 14% of men had a DXA (6% of AA and 29% of whites) compared with 29% of patients (21% for AA and 42% for whites) after the checklist was instituted in the clinic. Sixty-three percent of AA with rheumatoid arthritis had DXA compared with 65% of whites. Thirteen patients had osteoporosis whereas 16 had osteopenia.

Conclusions: The use of a check list of risk factors for osteoporosis may increase the appropriate use of DXA in male patients over the age of 50 at risk for osteoporosis.

MeSH terms

  • Absorptiometry, Photon*
  • Aged
  • Black or African American
  • Bone Density*
  • Clinical Competence
  • Critical Pathways*
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / diagnosis*
  • Osteoporosis / ethnology
  • Outpatient Clinics, Hospital
  • Physicians
  • Rheumatic Diseases / complications
  • Rheumatic Diseases / drug therapy
  • Steroids / adverse effects
  • White People

Substances

  • Steroids