The current recommendation for primary care
physicians to identify women at high risk of osteoporo-
sis relies on the assessment of clinical risk factors as a
selection method for referral for dual energy x ray
absorptiometry (DXA).
1
DXA remains the “gold stand-
ard” diagnostic investigation for osteoporosis, but the
restrictions of cost and availability necessitate an effec-
tive selection process. Little evidence exists about the
value of enquiring about risk factors in primary care as
a selection method, but it has been reported to be a
poor predictor of low bone mass.
2
Quantitative
ultrasound scanning can be used to predict risk of
osteoporotic fracture.
3
Preliminary findings indicate
that ultrasound scanning is as good as clinical risk fac-
tors for prediction of osteoporosis, but its role in
primary care has yet to be clarified.
4
We compared
these selection methods in postmenopausal women in
a primary care setting.