Is bone mineral density measurement useful in osteoporotic patients who have already fractured?

Osteoporosis is a common disease that manifests itself as fragility fractures occurring at multiple skeletal sites, mostly the spine, hip or wrist. Fractures affect up to onehalf of women and up to a third of men aged over 50 years, and are often associated with low bone density.1 These numbers are likely to increase with the increasing age of the population. According to the World Health Organization 1994 guidelines,2 osteoporosis is defined as a bone mineral density (BMD) that lies 2.5 standard deviations (SD) or more below the average value for young healthy women (ie, a T-score of <--2.5 SD). This criterion provides both a diagnostic and intervention threshold. The most widely-validated technique to measure