BMD

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Regions to report:

  • L1-L4 (if focal artifact / DDD, exclude affected vertebra but try to avoid reporting only 1 level)
  • Hip (Lowest of femoral neck or total hip)
  • Forearm (if needed) (33% or 1/3 radius)

Diagnosis is from lowest T-score above:

  • -1.0 or better - Normal
  • -1.01 to -2.49 - Osteopenia
  • -2.5 or worse - Osteoporosis

Ignore changes in BMD <3%

Changes in BMD >10% are usually measurement error

FRAX:

Pts treated if >50 AND [ osteoporotic OR hip/spine fracture OR { osteopenic AND (hip fracture risk >=3% OR major osteoporotic fracture risk >=20%) } ]

Only report FRAX in osteopenic patients, not already being treated, >50 y/o, without prior hip or vertebral fracture

VFA:

Fracture grading:

  • Grade 1: 20-25% height loss
  • Grade 2: 25-40%
  • Grade 3: >40%