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Last Updated: 9/12/2013  

Screening for Osteoporosis

  • Base the decision to screen for BMD on individual risk profile.

  • Screen for BMD among asymptomatic postmenopausal women aged 65 and older and asymptomatic men aged 75 and older.

  • Assess osteoporosis risk factors of premenopausal women by using a validated risk assessment tool such as FRAX.

  • Order BMD testing for asymptomatic postmenopausal women under age 65 if they are at increased risk on the basis of a validated risk assessment tool.

  • Consider screening for osteoporosis in men under age 75 with substantial risk factors.

  • Know that the most widely used and validated test for bone density is DXA.

  • Make decisions about treatment of documented osteoporosis on the basis of bone density values, the presence of prevalent vertebral fracture, and individual patient fracture risk.

  • Counsel all women about measures to reduce the risk for osteoporosis, including smoking cessation, maintenance of healthy body mass index, adequate calcium and vitamin D intake, and physical activity.

DOI: 10.7326/s675
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Alexandra Papaioannou, MD is a consultant for Merck Frosst, Aventis, Procter and Gamble, Eli Lilly, Novartis, received honorarium from Merck Frosst, Aventis, Procter and Gamble, Eli Lilly, Novartis, received grants from Merck Frosst, Aventis, Procter and Gamble, Eli Lilly, Novartis. Nicole Ferko, MSc has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Jonathan D. Adachi, MD is a consultant for Amgen, Astra Zeneca, Eli Lilly, GSK, Merck, Novartis, Pfizer, Proctor and Gamble, Roche, Servier, received honoraria from Amegen, Eli Lilly, GKS, Merck, Novartis, Pfizer, Proctor and Gamble, Roche, received grants from Merck, Proctor and Gamble, Eli Lilly, Amgen, perfomed clinical trials for Amgen, Astra Zeneca, Eli Lilly, GSK, Merck, Novartis, Pfizer, Proctor and Gamble, Roche, Servier. Elizabeth Koehler, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Nawal Atwan, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
The following editors of ACP Smart Medicine have nothing to disclose: Deborah Korenstein, MD, FACP, Editor in Chief; Richard B. Lynn, MD, FACP, Editor; and Davoren Chick, MD, Editor.
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