Risk Assessment for Osteoporosis Using Bone Mineral Density Determination: A Belgian Perspective

The availability of bone densitometry in daily clinical practice has revolutionized the capacity to detect osteoporosis, to estimate the risk of future fracture, and to select those patients who are likely to benefit most from preventive or therapeutic measures. In spite of the high availability of densitometry in Belgium and the high incidence of risk factors for osteoporosis in elderly women, osteoporosis is presumably underdiagnosed. It is likely that the limited use of widely available technology to evaluate osteoporosis results from a complex interaction of numerous factors, some of which are discussed. In spite of many unanswered questions, the main conclusion to be drawn from the Belgian experience is that a high density of densitometry facilities is no guarantee that the majority of women who are at greatest risk of fracture will actually become the focus of preventive measures or therapy.