Abstract
The goals of osteoporosis management consist in preventing osteoporotic fractures. It is vitally important that those at high risk of fracture proactively seek medical consultation and osteoporosis screening or bone health check-up programs play a major role in encouraging them to do so.
However, 70% of the healthcare facilities offering such programs draw on quantitative ultrasound (QUS) for bone health examinations. While being convenient and free from exposure to radiation, QUS involves different parameters and yields highly variable data depending on the equipment used. Thus, QUS is not only unsuitable as a modality for definitive diagnosis but also has a dubious role in screening.
Against this background, I would like to propose the use of microdensitometry (MD) in screening programs as a modality that allows not only osteoporosis screening but also diagnosis of osteoporosis. Furthermore, MD allows a large number of patients to be examined in a short time and does not require any further instrument beyond a radiographic imaging device, with the most recent of these devices requiring only half of the radiation dose required in conventional devices. I would also like to propose the use of “loco-check” in combination with MD, as it allows evaluation of locomotor function as part of bone health check-up programs.
Additionally, I would also like to propose the use of 25(OH)D, a measure of vitamin D, which is shown to be useful in detecting those with low bone mineral density and at high risk of bone fracture, while this marker has yet to be covered by health insurance.
Bone health check-up programs are intended to detect those potentially affected by osteoporosis for treatment. Thus, in this review, I have focused on how future bone health check-up programs may be envisioned in light of current osteoporosis management approaches.
