Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health Care

fractures. 5,6Another tool for identifying high-risk individuals is vertebral fracture assessment, a newer technology that assesses for fractures during DXA via lateral spinal views. 7 Most vertebral fractures are asymptomatic, but even an asymptomatic, nontraumatic vertebral fracture incurs a markedly increased risk of future vertebral and hip fracture.Thus, pharmacotherapy is recommended regardless of BMD.In conclusion, DXA reporting of T scores at nondiagnostic sites can result in confusion and potentially inappropriate use of antiosteoporosis medications.The T scores determined at the appropriate sites (ie, femoral neck, total hip, and total PA lumbar spine), combined with clinical risk factors (eg, prior fracture), should be used in the evaluation for skeletal fragility and in decision making about lifestyle and pharmacologic interventions.