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Editorial |

Bone Mass, Bone Fragility, and the Decision to Treat

Robert P. Heaney, MD
JAMA. 1998;280(24):2119-2120. doi:10.1001/jama.280.24.2119.
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The explosion of osteoporosis-related diagnostic and therapeutic options in the past 6 to 10 years has created its own challenges. Guidelines have recently been published concerning who should be tested1 but, in a sense, that issue is moot. Bone mass measurement technology is proliferating rapidly, and physicians increasingly are confronted with ostensibly healthy individuals who bring them a printout showing that they have low bone mass. Should the physician recommend one of the growing array of bisphosphonates, selective estrogen receptor modulators, hormone replacement therapy regimens, or dietary supplements? Normally, the clinician treats the patient, not a test, but when it comes to prevention, the test result may be all the physician has to go on.

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