There is an inverse relationship between Z-scores and the presence of causes of secondary osteoporosis.
However only a small difference in mean Z-scores of 0.3 between those with
and without secondary causes of osteoporosis was detected
[17].
Indeed, a study done in Singapore found that the traditional
Z-score value of 2 as an indicator of patients with
secondary cause of osteoporosis performed abysmally with a
sensitivity of less than or below 20.7% for both males and
A 50-year-old man presented with a Colles' fracture after
just a minor fall onto the ground where he used his outstretched
hand to break his fall. He was referred for management.
The BMD was as shown below