• vertebral fracture
• densitometry
• bone mineral density
• menopause

We read with interest the article by Nolla et al, which demonstrates that only 3% of patients with symptomatic non-traumatic vertebral fracture have normal bone mineral density (BMD).¹ We agree with their conclusions that in this clinical setting measurement of BMD is not required to confirm a diagnosis of osteoporosis before starting treatment.

A large number of studies have shown that a previous history of vertebral fracture increases the risk of future vertebral and non-vertebral fracture, independently of BMD.² Vertebral fractures are also associated with significant morbidity, leading to an impaired quality of life³ and increased mortality.⁴ A recent study by Lindsay et al demonstrated the speed of disease progression in osteoporosis, with …