Angela G. Juby, MD, Associate Professor, Department of Medicine, Division of Geriatrics, University of Alberta, Edmonton, AB.
David A. Hanley, MD, Professor, Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Calgary, AB.

Low bone density is major risk for osteoporotic fracture. In older adults special precautions apply in interpreting bone mineral density measurements (either by central dual energy X-ray absorptiometry [DXA] or peripherally with calcaneal ultrasonography). Clinical assessment for vertebral fractures is an important part of the management. Therapeutic regimes for osteoporosis treatment are complicated and require repeated reinforcement to ensure long term compliance. Adequate compliance (80%) is required for optimal therapeutic benefit.
Key words: calcaneal ultrasonography, central dual energy x-ray absorptiometry (DXA), bone mineral density (BMD), older adult, special precautions.