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The Effects of Race, Ethnicity, and Underlying Medical Diseases on Osteoporosis Are Still Unguided Territory for Internists
- Brittany Bohinc, MD; and
- John E. Snyder, MS, MD
- From New Hanover Regional Medical Center, Wilmington, NC 28401, and University of North Carolina School of Medicine at Chapel Hill, Chapel Hill, NC 27599.
TO THE EDITOR:
We were pleased to read the recently published American College of Physicians (ACP) clinical guidelines (1) and systematic review (2) on screening for osteoporosis in men. These articles represent closure of a substantial gap in previous guidelines issued to general internists, and we commend the authors and ACP for undertaking this project. Currently, Medicare coverage for bone mass measurements is limited to at-risk women with estrogen deficiency, individuals with vertebral radiographs suggestive of underlying osteoporosis, individuals receiving prolonged glucocorticoid therapy, patients with primary hyperparathyroidism, and those already taking osteoporosis medication (3). Hopefully, the new ACP guidelines will help extend Medicare coverage to include at-risk male patients, because out-of-pocket expenses for dual x-ray absorptiometry screening are approximately $180 at our institution.
Although the new …
