What are the guidelines for screening and monitoring osteoporosis?

Updated: Jan 19, 2021
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

The National Osteoporosis Foundation (NOF) recommends bone density testing for the following groups [37] :

  • Women aged 65 years or older and men aged 70 yearsor older.
  • Postmenopausal women younger than 65 years who have at least 1 additional risk factor.
  • Men aged 50-69 years with at least 1 additional risk factor.
  • Anyone who has had a fracture after aged 50 years.

In addition, the NOF recommends patients treated with osteoporosis medicine should repeat their bone density test by central DXA every 1-2 years. [37]

In postmenopausal women being treated for osteoporosis, the Endocrine Society suggests monitoring the bone mineral density by DEXA at the spine and hip every 1-3 years to assess the response to treatment. [38]

The American Association of Clinical Endocrinologists and the American College of Endocrinology guidelines for postmenopausal osteoporosis recommend BMD testing by DXA for postmenopausal women aged 50 years or older based on their risk profile. [39]

The UK National Osteoporosis Guideline Group (NOGG) recommends bone density measurements for postmenopausal women and for men aged 50 years or older who have risk factors for fracture. Clinical risk factors include the following [40] :

  • Low body mass index (BMI)
  • History of a prior fracture at a site characteristic for osteoporosis
  • Parental history of hip fracture
  • History of smoking
  • Glucocorticoid use
  • Alcohol consumption
  • Rheumatoid arthritis

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