clinical indications for bone densitometry

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These include:

  • a patient with a history of a low trauma fracture e.g. spine, hip, distal forearm
  • an incidental X-ray finding of osteopenia or vertebral collapse or in the investigation of thoracic kyphosis or loss of height
  • if there is maternal history of hip fracture
  • if the patient has a low body mass index (BMI < 19 kg/m^2)
  • if the patient has received corticosteroid treatment (prednisolone 7.5 mg or more) for greater than three months
  • oestrogen deficiency:
    • in a patient with premature menopause (< 45 years of age)
    • primary hypogonadism
    • secondary amenorrhoea (which lasts more than six months) e.g. secondary to GnRH anologues
  • where there are conditions that predispose to secondary osteoporosis including:
    • malabsorption syndromes e.g. coeliac disease, inflammatory bowel disease
    • long-term treatment with anticonvulsants
    • organ transplantation
    • eating disorders
    • chronic renal failure
    • thyrotoxicosis
    • primary hyperparathyroidism
    • Cushing's syndrome
    • male hypogonadism
    • prolonged immobilisation

Therefore it is inappropriate to scan premenopausal women without any additional risk factors apart from a family history of osteoporosis or patients with back pain unless there is X-ray evidence of a recent vertebral crush fracture (1).

Monitoring therapy - at intervals of at least 18 months (2)

Reference:

  1. GP magazine (16/3/01), 52.
  2. ARC.Hands On 2007;11:1-6.
  3. Osteoporosis Clinical guidelines for prevention and treatment. Update on pharmacological interventions and an algorithm for management. Royal College of Physicians, Bone and Tooth Society of Great Britain July 2000.

Last reviewed 07/2021

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