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%