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The Role of Bone Densitometry in Osteoporosis Treatment and Follow-Up

Mark P. Bowes, PhD

*Medical Writer, Portland, Oregon.
Address correspondence to: Mark P. Bowes, PhD, Medical Writer, 7135 SE 18th Avenue, Portland, OR, 97202. E-mail: mpbowes@gmail.com.

Disclosure Statement: Dr Bowes reports having no financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Determination of bone mineral density (BMD) is essential in the management of osteoporosis, including initial screening and diagnosis, treatment planning, and follow-up of disease progression and treatment response. Dual X-ray absorptiometry (DXA) is generally considered the "gold standard" for the assessment of BMD and estimation of fracture risk. Other approaches, such as quantitative ultrasound or computed tomography, are used less often. DXA BMD results are usually expressed in relation to the mean value for health young adults (T score) or to the mean value for individuals of the same age, race, and sex (Z score). BMD may be used in combination with clinical factors such as age, sex, body weight, family history, and medication use to calculate an estimated 10-year risk of fractures, which may be used in deciding whether osteoporosis therapy should be considered. Follow-up examinations are important to monitor disease progression and response to treatment. The timing of follow-up examinations depends on factors such as baseline BMD, precision of BMD assessment, and the expected rate of bone loss. This article reviews the rationale for BMD testing, the most common methods for evaluating BMD, and the manner in which densitometry results are used to diagnose osteoporosis and evaluate response to therapy.

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