Intended for healthcare professionals

Letters NICE on osteoporosis

Women over 75 with fragility fractures should have DEXA

BMJ 2009; 338 doi: (Published 09 June 2009) Cite this as: BMJ 2009;338:b2340
  1. Stuart H Ralston, ARC professor of rheumatology1,
  2. Gina de’Lara, osteoporosis specialist nurse1,
  3. Donald J Farquhar, consultant geriatrician2,
  4. Stephen J Gallacher, consultant physician3,
  5. Jim Hannan, consultant medical physicist1,
  6. Alastair R McLellan, consultant endocrinologist4
  1. 1Western General Hospital, Edinburgh EH4 2XU
  2. 2St John’s Hospital, Livingston EH54 6PP
  3. 3Southern General Hospital, Glasgow G51 4TF
  4. 4Western Infirmary, Glasgow G11 6NT
  1. Stuart.Ralston{at}

    The recent NICE guidance on osteoporosis has generated much controversy and the publication of “alternative” guidelines.1 An aspect which has escaped attention is the advice that bone density scanning by dual energy x ray absorptiometry (DEXA) may not be required in women aged ≥75 who have had a fragility fracture. This has been incorporated into the osteoporosis direct enhanced service agreement …

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