Osteoporosis screening recommendations
|National Osteoporosis Foundation (NOF)||The NOF recommends measurement of BMD (DXA of the hip and spine) in:|
|• Women age 65 years and older and men age 70 years and older, regardless of clinical risk factors|
|• Younger postmenopausal women, women in the menopausal transition, and men age 50 to 69 years with clinical risk factors for fracture|
|• Adults who have a fracture after age 50 years|
|• Adults with a condition (eg, rheumatoid arthritis) or taking a medication (eg, glucocorticoids in a daily dose ≥5 mg prednisone or equivalent for ≥3 months) associated with low bone mass or bone loss|
|International Society for Clinical Densitometry (ISCD)||The ISCD recommends measurement of BMD (DXA of the hip and spine) in:|
|• All women age 65 years and older and men age 70 years and older regardless of risk factors|
|• Postmenopausal women and men age 50 to 70 years when risk factors are present|
|• Adults with a fragility fracture|
|• Adults with a condition or taking a medication associated with low bone mass or bone loss|
|• Anyone being considered for pharmacologic therapy for osteoporosis|
|• Anyone being treated for osteoporosis to monitor response to therapy|
|• Anyone not receiving therapy when evidence of bone loss would lead to treatment|
|• Women in the menopausal transition if there is a specific risk factor associated with increased fracture, such as low body weight, prior low-trauma fracture, or high-risk medication|
|• Postmenopausal women discontinuing estrogen should be considered for bone density testing|
|• The 33 percent forearm (1/3 radius) site is recommended in the following cases:|
|- If hip and/or spine cannot be measured or interpreted|
|- Severe obesity (over the weight limit of DXA table)|
|Association of Clinical Endocrinologists (AACE)||AACE recommends measurement of BMD (DXA) in:|
|• All women age 65 years and older|
|• Any adult with a history of fracture not caused by severe trauma|
|• Younger postmenopausal women with clinical risk factors for fracture|
|• The lumbar spine (PA) and proximal femur are recommended sites of measurement|
|United States Preventive Services Task Force (USPSTF)||USPSTF recommends measurements of BMD in:|
|• All women age 65 years and older|
|• In addition, they recommend screening in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors|
|• The best site to screen is not mentioned, although the report agrees that DXA of the hip is the best predictor of hip fracture|
|American Academy of Family Physicians (AAFP)||The AAFP recommends measurement of BMD in:|
|• Women age 65 years and older|
|• Women age 60 years and older at increased risk for osteoporotic fracture|
|National Institutes of Health (NIH)||The NIH recommends:|
|• BMD measurements for individuals at high risk for osteoporosis. They do not recommend universal screening.|
|UK National Osteoporosis Guideline Group (NOGG)||The NOGG does not recommend population screening. They are in favor of performing BMD measurements using a case-finding strategy based upon age-specific fracture probability thresholds.|
|Canadian Osteoporosis Society||The Canadian Osteoporosis Society recommends BMD measurement in:|
|• Postmenopausal women age ≥65 years|
|• Men age ≥65 years|
|• Younger men and women with additional clinical risk factors for fracture|
BMD: bone mineral density: DXA: dual-energy x-ray absorptiometry.
- National Ostoporosis Foundation. 2013 Clinician's Guide to Prevention and Treatment of Osteoporosis. http://nof/public/content/resource/913/files/580.pdf (Accessed on November 14, 2013).
- International Society for Clinical Densitometry. 2013 ISCD Official Positions - Adult. www.iscd.org/official-positions/2013-iscd-official-positions-adult/ (Accessed on November 14, 2013).
- American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Postmenopausal Osteoporosis. www.aace.com/pub/pdf/guidelines/OsteoGuidelines2010.pdf (Accessed on January 10, 2011).
- U.S. Preventive Services Task Force. Screening for Osteoporosis Recommendation Statement. www.uspreventiveservicestaskforce.org/uspstf10/osteoporosis/osteors.htm (Accessed on February 10, 2011).
- American Academy of Family Physicians. Recommendations for clinical preventative services. www.aafp.org/exam.xml (Accessed on January 10, 2011).
- www.consensus.nih.gov (Accessed on January 10, 2011).
- National Osteoporosis Guideline Group (NOGG). www.shef.ac.uk/NOGG/index.html (Accessed on June 29, 2011).
- Papaioannou A, Morin S, Cheung AM, et al. 2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: Summary. CMAJ 2010; 182:1864.
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