Osteoporosis: the emperor has no clothes.
Bottom Line: However, all these three notions can be disputed.A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty.There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20-25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment.
Affiliation: Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.Show MeSH
Related in: MedlinePlus
Mentions: Further, the DXA measurement inherently assumes that the scanned body region (e.g. hip or lumbar spine) comprises only bone and homogeneous soft tissue components, but it is clear that this two-component simplification conflicts with clinical reality (individual anatomy and body composition), resulting in substantial inaccuracy of individual measurement (Fig.3a). Despite the fact that DXA measurements are highly repeatable, the measurement accuracy is important with regard to estimated bone strength. The inherent uncertainty in the BMD measurement can correspond to one T-score unit to either direction or even more [48–50]. For example, a measured T-score of −2.5 (indicating osteoporosis) can reflect a true T-score of between −3.5 (clear osteoporosis) and −1.5 (slight osteopenia) without any possibility of knowing the true value for the given individual (Fig.3b). Therefore, even large individual changes in BMD, corresponding to those typically observed in clinical trials, may become irrelevant in terms of fracture prediction .
Affiliation: Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.