Radiol Manage. 1998 Mar-Apr;20(2):43-54.
This report provides general information about osteoporosis and describes the use of bone densitometry as a tool to screen for, diagnose and manage osteoporosis in white postmenopausal women. Discussion is limited to white women because of lack of research on osteoporosis in men, and in women of different racial and ethnic groups. The report does not evaluate the safety and efficacy of all bone densitometry devices, but focuses on the two diffusing most rapidly in Minnesota--dual x-ray absorptiometry (DXA or DEXA) and quantitative computed tomography (QCT). Osteoporosis is a degenerative bone disease that affects approximately 24 million Americans. Of that number 33 percent are post-menopausal women who have decreased bone density due to lowered estrogen levels. Because the estimated cost of osteoporosis-related fractures in the United States is between $8 and $10 billion each year, there is great interest in the diagnosis, prevention and treatment of the disease. Of all related fractures, hip fractures pose the most serious health problem. The incidence of this fracture appears to be increasing, with 250,000 to 300,000 occurring each year Treatment options are limited, if a person's bone mass or density has deteriorated to the point where fractures may occur. Preventive measures should therefore be undertaken by all women early in life to decrease their risk of osteoporosis. Based on available evidence, the HTAC concludes that state-of-the-art bone densitometry is safe and indicated as a diagnostic and treatment aid for postmenopausal women at risk for the disease. However, bone densitometry is not indicated as a broad screening tool for all postmenopausal women, regardless of whether they are at risk for the disease.
本报告提供了有关骨质疏松症的一般信息，并描述了骨密度测定作为一种筛查、诊断和管理绝经后白人女性骨质疏松症的工具的使用情况。由于缺乏对男性以及不同种族和族裔女性骨质疏松症的研究，讨论仅限于白人女性。本报告未评估所有骨密度测定设备的安全性和有效性，而是重点关注在明尼苏达州传播最迅速的两种设备——双能X线吸收法（DXA或DEXA）和定量计算机断层扫描（QCT）。骨质疏松症是一种退行性骨病，约影响2400万美国人。其中33%是绝经后女性，她们因雌激素水平降低而骨密度下降。由于美国每年与骨质疏松症相关骨折的估计费用在80亿至100亿美元之间，因此对该疾病的诊断、预防和治疗非常关注。在所有相关骨折中，髋部骨折带来的健康问题最为严重。这种骨折的发病率似乎在上升，每年发生25万至30万例。如果一个人的骨量或骨密度已经恶化到可能发生骨折的程度，治疗选择就很有限。因此，所有女性都应在早年采取预防措施，以降低患骨质疏松症的风险。基于现有证据，HTAC得出结论，先进的骨密度测定是安全的，可作为对有患该疾病风险的绝经后女性的诊断和治疗辅助手段。然而，骨密度测定并不适用于所有绝经后女性的广泛筛查工具，无论她们是否有患该疾病的风险。
