Can we detect women with low bone mass using clinical risk factors?

The magnitude of osteoporosis, the established relationship between low bone mass and the risk of fracture, and the availability of preventive treatment suggest that the early detection of women with low bone mass is justified. The feasibility of population screening using bone mass measurements remains controversial. Another approach is the use of clinical risk factors to detect women at high risk. However, several studies have demonstrated that the assessment of risk factor status does not appear to be an efficient tool for the identification of perimenopausal women with low bone mass. The poor performance of the prediction models might be explained in part by unmeasured factors, especially genetic factors, which are an important determinant of bone mass. On the other hand, the clinical usefulness of clinical risk factors needs to be more precisely evaluated, especially in the detection of women at high risk for hip fracture.