Following is a statement by the National Osteoporosis Foundation on Bone Mineral Density Testing

Osteoporosis is a silent disease until it is complicated by fractures—fractures that can occur following minimal trauma. These fractures are common and place an enormous medical and personal burden on aging individuals and a major economic toll on the nation. Osteoporosis can be prevented and can be diagnosed and treated before any fracture occurs. Importantly, even after the first fracture has occurred, there are effective treatments to decrease the risk of further fractures. Prevention, detection and treatment of osteoporosis should be a mandate of primary care providers.

National Osteoporosis Foundation (NOF) recommends a comprehensive approach to the diagnosis and management of osteoporosis. A detailed history and physical examination together with BMD assessment and, where appropriate, the WHO 10-year estimated fracture probability are utilized to establish the individual patient’s fracture risk. The potential risks and benefits of all osteoporosis interventions should be reviewed with patients and the unique concerns and expectations of individual patients considered in any final therapeutic decision.

Utilizing any procedure to measure bone density is not indicated unless the results will influence the patient's treatment decision. NOF recommends testing of all women age 65 and older. NOF also recommends testing of men age 70 and older. BMD measurement is not recommended in children or adolescents and is not routinely indicated in healthy young men or premenopausal women.

In accordance with NOF's Clinician's Guide, the following are NOF's indications for BMD Testing:

Women age 65 and older and men age 70 and older, regardless of clinical risk factors

• Younger postmenopausal women and men age 50 to 69 about whom you have concern based on their clinical risk factor profile
• Women in the menopausal transition if there is a specific risk factor associated with increased fracture risk such as low body weight, prior low-trauma fracture or high risk medication
• Adults who have a fracture after age 50
• Adults with a condition (e.g., rheumatoid arthritis) or taking a medication (e.g., glucocorticoids in a daily dose ≥ 5 mg prednisone or equivalent for ≥ three months) associated with low bone mass or bone loss
• Anyone being considered for pharmacologic therapy for osteoporosis
• Anyone being treated for osteoporosis, to monitor treatment effect
• Anyone not receiving therapy in whom evidence of bone loss would lead to treatment
• Postmenopausal women discontinuing estrogen should be considered for bone density testing

About the National Osteoporosis Foundation

Established in 1984, the National Osteoporosis Foundation, a leading community-focused health organization, is dedicated to the prevention of osteoporosis and broken bones, the promotion of strong bones for life and the reduction of human suffering through programs of awareness, education, advocacy and research. For more information on the National Osteoporosis Foundation, visit www.nof.org.