Ulnar bone fracture screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;

Overview

Generally the risk of human bone fracture such as ulnar bone fracture can be due to osteoporosis is an important fact in orthopedic medicine.

It’s been reported that around 10% of women with the age of 50≤ years old have to have the bone mineral density (BMD) evaluations after a forearm fracture and consequently having the the with anti-osteoporotic drug prescription

Screening

Osteoporosis is an important risk factor for human affecting human bone especially in men with the age of older than 50 years old and postmenopausal and women[1][2][3][4][5].

Based on the US Preventive Services Task Force (USPSTF) there are three groups of patients need to be screened for the osteoporosis:

  • ·       Men with no history of osteoporosis
  • ·       Women with the age of 65≤ year old, with no previous history of pathological fracture due to the osteoporosis
  • ·       Women with the age of <65 years, with 10-year fracture risk of not less than a 65-year-old white woman (who has not any other risk factor)

Accordingly women older than age of 50 are the main target for the osteoporosis screening. There is no specific recommendation to screen men for the osteoporosis.

The USPSTF recommendations from 2002 included:

Meanwhile, there are two major modalities for the osteoporosis screening:

  1. ·       Dual energy x-ray absorptiometry (DXA) of the hip and lumbar spine bones
  2. ·       Quantitative ultrasonography of the calcaneus

*It should be noted of the two above mentioned modalities for screening the ultrasonograhy is preferred to the DXA due to its lower cost, lower ionizing radiation, more availability.

After the primary evaluation of the osteoporosis, the further evaluation are required in some cases such as:

·       Women with normal bone density or mild osteopenia: T-score of greater than −1.50 – should have screening for 15 years.

·       Women with moderate osteopenia: T-score of −1.50 to −1.99 – should have screening for 5 years.

·       Women with advanced osteopenia: T-score of −2.00 to −2.49 - should have screening for 1 year.

References

  1. Ensrud KE, Crandall CJ (August 2017). "Osteoporosis". Ann. Intern. Med. 167 (3): ITC17–ITC32. doi:10.7326/AITC201708010. PMID 28761958.
  2. Si L, Winzenberg TM, Chen M, Jiang Q, Neil A, Palmer AJ (July 2016). "Screening for osteoporosis in Chinese post-menopausal women: a health economic modelling study". Osteoporos Int. 27 (7): 2259–2269. doi:10.1007/s00198-016-3502-1. PMID 26815042.
  3. Diab DL, Watts NB (December 2013). "Postmenopausal osteoporosis". Curr Opin Endocrinol Diabetes Obes. 20 (6): 501–9. doi:10.1097/01.med.0000436194.10599.94. PMID 24150190.
  4. Tella SH, Gallagher JC (July 2014). "Prevention and treatment of postmenopausal osteoporosis". J. Steroid Biochem. Mol. Biol. 142: 155–70. doi:10.1016/j.jsbmb.2013.09.008. PMC 4187361. PMID 24176761.
  5. Amarnath AL, Franks P, Robbins JA, Xing G, Fenton JJ (December 2015). "Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study". J Gen Intern Med. 30 (12): 1733–40. doi:10.1007/s11606-015-3349-8. PMC 4636552. PMID 25986135.