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• W2007667198 endingPage "2890" @default.
• W2007667198 startingPage "2890" @default.
• W2007667198 abstract "ContextAlthough recent US Preventive Services Task Force guidelines recommend bone densitometry for all women older than 65 years, identifying younger women at increased risk for osteoporosis and women with occult vertebral fractures remains a clinical challenge. We investigated whether physical signs are useful as a screening tool either for early referral to bone densitometry or for occult spinal fractures.ObjectiveTo review the accuracy and precision of physical examination findings for the diagnosis of osteopenia, osteoporosis, or spinal fracture.Data SourcesWe conducted a MEDLINE search for articles published from 1966 through August 2004, manually reviewed bibliographies, consulted 4 clinical skills textbooks, and contacted experts in the field.Study SelectionStudies were included if they contained adequate original data on the accuracy or precision of physical examination for diagnosing osteopenia, osteoporosis, or spinal fracture. Two authors screened abstracts found by the search. Fourteen of 191 full articles reviewed met inclusion criteria.Data ExtractionTwo authors independently abstracted data from the included studies. Disagreements were resolved by discussion.Data SynthesisNo single maneuver is sufficient to rule in or rule out osteoporosis or spinal fracture without further testing. The following yielded the greatest positive likelihood ratios (LR+): weight less than 51 kg, LR+, 7.3 (95% confidence interval [CI], 5.0-10.8); tooth count less than 20, LR+, 3.4 (95% CI, 1.4-8.0); rib-pelvis distance less than 2 finger breadths, LR+, 3.8 (95% CI, 2.9-5.1); wall-occiput distance greater than 0 cm, LR+, 4.6 (95% CI, 2.9-7.3), and self-reported humped back, LR+, 3.0 (95% CI, 2.2-4.1).ConclusionsIn patients who do not meet current bone mineral density screening recommendations, several convenient examination maneuvers, especially low weight, can significantly change the pretest probability of osteoporosis and suggest the need for earlier screening. Wall-occiput distance greater than 0 cm and rib-pelvis distance less than 2 fingerbreadths suggest the presence of occult spinal fracture." @default.
• W2007667198 created "2016-06-24" @default.
• W2007667198 creator A5054780474 @default.
• W2007667198 date "2004-12-15" @default.
• W2007667198 modified "2023-10-18" @default.
• W2007667198 title "Does This Woman Have Osteoporosis?" @default.
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• W2007667198 doi "https://doi.org/10.1001/jama.292.23.2890" @default.
• W2007667198 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15598921" @default.
• W2007667198 hasPublicationYear "2004" @default.
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