The Journal of Bone and Joint Surgery, Vol 69, Issue 2 212-218, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Assessment of the risk of vertebral fracture in menopausal women
JR Buchanan, C Myers, RB Greer, T Lloyd and LA Varano
The decision to institute prophylaxis in women with menopausal osteopenia
is hampered by the absence of quantitative criteria for appraising the risk
of fracture in the individual. We have developed standards for assessing
the risk of fracture by relating the prevalence of atraumatic vertebral
compression fractures to bone density in sixty-five menopausal women,
forty-nine to ninety-two years old. To define the upper limit of the
spectrum of bone density, we also studied thirty-one young women, seventeen
to twenty-two years old. The density of trabecular bone in a vertebral body
was determined by quantitative computed tomography and expressed in terms
of milligrams per milliliter of dipotassium hydrogen phosphate. Twenty-five
of the menopausal women exhibited at least one fracture (range, one to six
fractures), and forty had no fracture. The bone density ranged from -9 to
sixty-nine milligrams per milliliter in those with fractures and from
twelve to 122 milligrams per milliliter in those without a fracture. The
densities in the young women averaged 173 milligrams per milliliter and
ranged from ninety-five to 248 milligrams per milliliter. The percentage of
subjects with fractures increased as the bone density decreased. It was
zero per cent in women with a density of seventy milligrams per milliliter
or more, 38 per cent in women with a density between fifty and less than
seventy milligrams per milliliter, 71 per cent in those with a density
between thirty and less than fifty milligrams per milliliter, and 82 per
cent in women with a density of less than thirty milligrams per
milliliter.(ABSTRACT TRUNCATED AT 250 WORDS)
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