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For BMD measurement, axial dual-energy x-ray absorptiometry (DXA)(lumbar spine and hip; 1/3 radius if indicated) is recommended.The AACE recommends BMD testing in the following patientsOther indications for BMD tesing include the followingThe 2014 NOF guidelines recommend BMD measurement in the following patientsThe 2015 ISCD Official Positions recommend BMD testing in the following patientsPostmenopausal women younger than age 65 with a risk factor for low bone mass (eg, low body weight, prior fracture, high-risk medication use, disease or condition associated with bone loss)Women during the menopausal transition with clinical risk factors for fracture (eg, low body weight, prior fracture, high-risk medication use)Men younger than 70 years with a risk factor for low bone mass (eg, low body weight, prior fracture, high-risk medication use, disease or condition associated with bone loss)Adults with a disease or condition associated with low bone mass or bone lossAdults taking medications associated with low bone mass or bone lossAnyone not receiving therapy in whom evidence of bone loss would lead to treatmentWomen discontinuing estrogen should be considered for bone density testing according to the indications listed above.The USPSTF recommends measuring BMD in the following patientsPostmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment toolSuggested risk assessment tools include the following:In contrast to the NOF and ISCD, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening to prevent osteoporotic fractures in men.According to National Osteoporosis Foundation guidelines, a clinical diagnosis of osteoporosis may be made in a postmenopausal woman or in a man over age 50 years who is at an elevated risk for fracture, as indicated by any of the followingThe 2020 update of the American Association of Clinical Endocrinologists (AACE) guidelines provides the following criteria for the diagnosis of osteoporosis in postmenopausal womenThe National Osteoporosis Foundation (NOF) recommends that pharmacologic therapy should be reserved for postmenopausal women and men aged 50 years or older who present with the followingA hip or vertebral fracture (vertebral fractures may be clinical or morphometric [ie, identified on a radiograph alone])T-score of –2.5 or less at the femoral neck or spine after appropriate evaluation to exclude secondary causesLow bone mass (T-score between –1.0 and –2.5 at the femoral neck or spine) and a 10-year probability of a hip fracture of 3% or greater or a 10-year probability of a major osteoporosis-related fracture of 20% or greater based on the The 2020 updated guidelines from the American Association of Clinical Endocrinologists (AACE) are similar to NOF guidelines.
Your Account & Tools Bass MA, Sharma A, Nahar VK, Chelf S, Zeller B, Pham L, et al. The document is cosponsored by the European Society of Endocrinology.
Kanis JA. 2002;359(9321):1929-1936. Geusens P, Dumitrescu B, van Geel T, van Helden S, Vanhoof J, Dinant GJ.
Example of a dual energy x-ray absorption (DXA) scan. Majumdar SR, Lier DA, Beaupre LA, Hanley DA, Maksymowych WP, Juby AG, et al. U.S. Food & Drug Administration. Lau AN, Adachi JD. Inactive osteoporosis is the most common form and manifests itself without active osteoid formation. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, et al. Vertebral; proximal humerus; pelvis; or, in some cases, distal forearm fracture in the setting of low bone mass (osteopenia) confirmed by DXA Kanis JA. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Faulkner KG, Wacker WK, Barden HS, Simonelli C, Burke PK, Ragi S, et al. Selecting patients for osteoporosis therapy. 2017 update (Slovak Rep. Ministry of Health Guidelines for the Diagnosis and Treatment of Patients with Osteoporotic FracturesSlovak Rep. Ministry of Health Guidelines for the Diagnosis and Treatment of Osteoporosis Calcium/vitamin D supplementation and cardiovascular events. Liu G, Peacock M, Eilam O, Dorulla G, Braunstein E, Johnston CC. Czerwinski E, Badurski JE, Marcinowska-Suchowierska E, Osieleniec J. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Impact of systematic implementation of a clinical case finding strategy on diagnosis and therapy of postmenopausal osteoporosis. Michel JP, Hoffmeyer P, Klopfenstein C, et al.
Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. Simple Calculated Osteoporosis Risk Estimation (SCORE) Hillier TA, Stone KL, Bauer DC, Rizzo JH, Pedula KL, Cauley JA, et al.
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