Forearm bone densitometry examination predicts the relative risk of osteoporotic fracture, but not as reliably as central densitometry of the hip and spine. The ease of performance, inexpensiveness, and mobility of this technique makes it especially appealing in rural states like West Virginia. After evaluating 1,321 Caucasian women in West Virginia by peripheral bone densitometry at the proximal 1/3 radius region, we found a 26.6% prevalence of osteoporosis. This is higher when compared to estimates using central densitometry and could potentially lead to overprescribing of expensive medications. Although central densitometry is the preferred method for the diagnosis of osteoporosis, women ages 65 or older with osteoporosis identified by peripheral densitometry should likewise be treated. Clinical risk factors should be present before initiating treatment in younger postmenopausal women ages 50-64. In those women without risk factors, confirmation by central densitometry should be performed if possible.
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