ISCD Official Positions

Question 1

In which four conditions is BMD testing indicated for post-menopausal women younger than age 65?

Answer 1

• low body weight
• prior fracture
• high risk medication use
• disease or condition associated with bone loss

Question 2

At what age is BMD testing indicated for men?

Answer 2

Men aged 70 or older

Question 3

In which four conditions is BMD testing indicated for men younger than age 70?

Answer 3

• low body weight
• prior fracture
• high risk medication use
• disease or condition associated with bone loss

Question 4

Should women discontinuing estrogen be considered for BMD testing?

Answer 4

Yes

Question 5

Bone mineral density should be tested in patients receiving treatment to monitor therapy effect.

True or false?

Answer 5

True

Question 6

What race is used for the female normative database to compare bone density in all ethnic groups?

Answer 6

Caucasian

Question 7

What reference standard should manufacturers use for femoral neck and total hip T-scores?

Answer 7

NHANES III

Question 8

What reference standard should manufacturers use for lumbar spine T-scores?

Answer 8

Their own databases

Question 9

What reference data should manufacturers use if local reference data is not available?

Answer 9

They should report only Z-scores but not T-scores

Question 10

How old do women have to be for bone mineral density testing to be indicated?

Answer 10

Women aged 65 and older

Question 11

What is the WHO reference standard from which the T-score is calculated?

Answer 11

• female
• Caucasian/white
• age 20-29 years
• NHANES III database

Question 12

How old do patients have to be for osteoporosis to be diagnosed?

Answer 12

50 years or older

Question 13

Should Ward’s area be used for diagnosis of osteoporosis?

Answer 13

No

Question 14

When should the forearm BMD be measured?

Answer 14

• Hip and/or spine cannot be measured or interpreted
• Hyperparathyroidism
• Very obese patients (over weight limit for DXA table)

Question 15

What is the spine region of interest (ROI)?

Answer 15

PA L1-L4

Question 16

Should a diagnosis of osteoporosis be made on the basis of one evaluable vertebra?

Answer 16

No

If this is the case a different valid skeletal site should be used

Question 17

The T-score difference between adjacent vertebrae should be less than ____ otherwise one of the vertebrae is abnormal.

Answer 17

1.0

Question 18

Should the lateral spine be used for diagnosis of osteoporosis?

Answer 18

No

Question 19

Can the lateral spine be used for monitoring of osteoporosis?

Answer 19

Yes

Question 20

Should the femoral neck or total proximal femur be used for diagnosis of osteoporosis?

Answer 20

Whichever is lowest

Question 21

Which hip should BMD be measured at?

Answer 21

It can be measured at either hip

Question 22

Can mean T-scores for bilateral hip BMD be used for osteoporosis diagnosis?

Answer 22

There is insufficient data to determine this.

Question 23

Can mean T-scores for bilateral hip BMD be used for monitoring of osteoporosis treatment?

Answer 23

Yes

Total hip is preferred