{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:39:43Z","timestamp":1787600383992,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Screening for osteoporosis is mainly done by measuring bone mineral density using dual-energy X-ray absorptiometry (DXA) scan. Screening does not usually start until 65\u2009years. Many people 50 to 65\u2009years may unknowingly suffer from progressive bone loss and may be at risk of osteoporosis. Opportunistic use of chest X-rays obtained for other indications could potentially be used to identify patients with signs of bone demineralization and at risk of osteoporosis in primary care settings particularly where DXA may not be readily available. We aimed at comparing the prevalence of bone demineralization using chest radiographs obtained for any indication in patients 50 to 65\u2009years seen at an emergency department, as assessed from their radiology reports and by independent review by a radiologist. We also sought to explore clinical and demographic associates of low bone mass (LBM) among this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a cross-sectional review of electronic medical records of patients 50 to 65\u2009years, who had obtained a chest X-ray at the emergency department of a large Level 1 trauma center in an urban teaching hospital between May 1, 2021, and May 31, 2021. We estimated the prevalence of \u201cbone demineralization\u201d from the X-rays reports and compared it with that obtained by an independent radiologist\u2019s review. We also used the 2020 US population census figures to estimate the number of people 50 to 65\u2009years potentially at risk of LBM and investigated demographic and clinical correlates of LBM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We reviewed 390 patient records, comprising 201 (51.5%) males and 189 (48.5%) females. Bone demineralization comment was found in 4 (1.0%) reports while radiologist review found 49 (12.6%). Applying sex-adjusted prevalence of 13.1% (using the direct method, with the 2020 US population as standard) to the 64.1\u2009million adults 50 to 64\u2009years in the US population, we estimated that approximately 8.4\u2009million people will have bone demineralization in the population group. LBM was associated with hypertension in women (OR\u2009=\u20092.41, 95% CI\u2009=\u20091.03-5.64).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Use of opportunistic chest X-rays may be feasible in identifying patients at risk of bone loss outside the traditional screening age particularly in areas where DXA may not be readily available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319251353372","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T11:41:23Z","timestamp":1752493283000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Opportunistic Use of Chest X-Ray for Identifying Older Adults at risk of Osteoporosis and not Meeting Criteria for Screening"],"prefix":"10.1177","volume":"16","author":[{"given":"Naga Ramesh","family":"Chinapuvvula","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, University of Texas McGovern Medical School, Houston TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7331-5019","authenticated-orcid":false,"given":"Marsha","family":"Hatley","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Texas McGovern Medical School, Houston TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raia","family":"Khan","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Texas McGovern Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Awiwi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, University of Texas McGovern Medical School, Houston TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-8117","authenticated-orcid":false,"given":"Jude","family":"des Bordes","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Texas McGovern Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-5836","authenticated-orcid":false,"given":"Nahid","family":"Rianon","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Texas McGovern Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Bone Health and Osteoporosis Foundation. What is Osteoporosis and What Causes It? 2024. Accessed February 12 2024. https:\/\/www.bonehealthandosteoporosis.org\/patients\/what-is-osteoporosis\/"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.7498"},{"key":"e_1_3_2_4_2","unstructured":"Centre for Metabolic Diseases University of Sheffield. FRAX: Fracture Risk Assessment Tool. 2024. Accessed June 10 2025. https:\/\/frax.shef.ac.uk\/FRAX\/reference.aspx"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04124-9"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejm196901232800405"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.25259\/IJMSR_51_2019"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10092323"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2023.07.024"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-022-00811-8"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2171-y"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjro.20210053"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.905"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2015.08.010"},{"key":"e_1_3_2_15_2","unstructured":"United States Census Bureau. 2020: DEC Demographic Profile. 2024. Accessed February 9 2024. https:\/\/data.census.gov\/table?g=010XX00US&d=DEC+Demographic+Profile"},{"key":"e_1_3_2_16_2","unstructured":"Bone Health and Osteoporosis Foundation. 54 Million Americans Affected by Osteoporosis and Low Bone Mass. 2024. Accessed February 9 2024. https:\/\/www.bonehealthandosteoporosis.org\/2014\/06\/02\/54-million-americans-affected-by-osteoporosis-and-low-bone-mass\/"},{"key":"e_1_3_2_17_2","unstructured":"Bone Health and Osteoporosis Foundation. New National Survey Reveals 82 Percent of Postmenopausal Women Miss Critical Connection Between Osteoporosis and Bone Fractures. Bone Health and Osteoporosis Foundation. 2017. Accessed February 16 2024. https:\/\/www.bonehealthandosteoporosis.org\/news\/new-national-survey-reveals-82-percent-postmenopausal-women-miss-critical-connection-osteoporosis-bone-fractures\/"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v5.i11.398"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2020.115561"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-012-2521-3"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956797613479386"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-199002000-00006"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medntd.2020.100047"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(99)01437-3"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319251353372","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319251353372","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319251353372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:23:19Z","timestamp":1777508599000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319251353372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":23,"alternative-id":["10.1177\/21501319251353372"],"URL":"https:\/\/doi.org\/10.1177\/21501319251353372","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,14]]},"article-number":"21501319251353372"}}