An audit of bone densitometry practice with reference to ISCD, IOF and NOF guidelines

Abstract

Compared to current clinical practice, application of the ISCD, IOF and NOF guidelines may increase the predictive value of a central DXA for osteoporosis.

Asymmetrical Hip Bone Density in Multiple Sclerosis

“…17 Individuals at increased risk include those with dementia, poor health, recent falls, prolonged immobilization, smoking, alcohol intake of 3 or more units per day, low body weight, overactive or underactive thyroid gland, fragility, fracture in a first-degree relative, earlyonset estrogen deficiency (<45 years), physical inactivity, a disease or condition that can cause bone loss (such as rheumatoid arthritis or anorexia nervosa), and steroid use for more than 3 months. 17 It is less clear whether lower-extremity paresis or having a neurologic disease is considered to raise the risk of bone loss in individuals who remain ambulatory.…”

“…Participants were positioned according to conventional procedures. 17 Bone density measurements are typically expressed as absolute (g/cm 2 ) and relative (T-and Z-score) values. The T score represents the number of standard deviations above or below the mean in comparison with a young adult (healthy 20-40-year-old) of the same sex and ethnicity, while the Z score represents the number of standard deviations above or below the mean in comparison with the agematched reference mean as supplied by the manufacturer (GE Healthcare, which uses the National Health and Nutrition Examination Survey [NHANES] database).…”

Interpreting a DXA Scan in Clinical Practice

“…Most official groups recommend screening healthy women for osteoporosis at age 65, and testing higher-risk women earlier (Baddoura, Awada et al 2006). In Europe the recommendations are to screen for risk factors of osteoporosis and to perform BMD measurement in women with such risks.…”

First Update of the Lebanese Guidelines for Osteoporosis Assessment and Treatment

“…This might be explained by differences in body size, chronic vitamin D deficiency, lower calcium intake and physical activity and genetic factors [21][22][24][25][26][27]. However, the prevalence of vertebral fractures in postmenopausal women and hip fracture rates are comparable to those for Western counterparts [28][29][30][31]. Finally, as importantly, mean BMD in Lebanese subjects with hip fracture is comparable to that in hip fracture subjects from the West [30,32].…”

“…Because of the wide use of densitometry testing in premenopausal women and of unindicated pharmacologic therapy in this group [29], recommendations in premenopausal women were reiterated in this update.…”