Most expert groups recommend monitoring time interval of 1 to 2 years if there is a high risk for accelerated bone loss, but otherwise every 2 years if there are risk factors [24]. DXA The literature indicates that DXA is the primary modality by which to monitor BMD in premenopausal women as well as adult men <50 years of age with risk factors [24]. The need for follow-up DXA is dictated by the clinical circumstance of the patients. QCT QCT is regarded as a secondary or adjunct tool to DXA. QCT may allow for monitoring BMD in premenopausal women and men between 20 to 50 years of age with risk factors. QCT demonstrates excellent precision and reproducibility to changes [31]. QUS There is insufficient evidence to support the use of QUS to monitor premenopausal women or adult men <50 years of age with risk factors. SXA There is insufficient evidence to support the use of SXA to monitor premenopausal women or adult men <50 years of age with risk factors. TBS There is insufficient evidence to support the use of TBS to monitor premenopausal women or adult men <50 years of age with risk factors. Variant 6: Males and females greater than or equal to 50 years of age. Suspected osteoporosis. Advanced degenerative changes of the spine with or without scoliosis, or other conditions that may spuriously elevate BMD. Initial imaging. DXA DXA allows for screening patients with risk factors and advanced degenerative changes in the spine. In a routine DXA examination, both the lumbar spine and hip are scanned and measured. Owing to the projectional nature of DXA, spuriously elevated BMD values of the lumbar spine may be caused by spondylosis and degenerative facet osteoarthritis or dense overlying tissue. Reportedly, in examinations with falsely elevated measurements, the most common cause (>81%) is degenerative disease of the spine [110]. The ISCD recommends close inspection of the images and associated BMD values to monitor levels for exclusion.
Osteoporosis and Bone Mineral Density. Most expert groups recommend monitoring time interval of 1 to 2 years if there is a high risk for accelerated bone loss, but otherwise every 2 years if there are risk factors [24]. DXA The literature indicates that DXA is the primary modality by which to monitor BMD in premenopausal women as well as adult men <50 years of age with risk factors [24]. The need for follow-up DXA is dictated by the clinical circumstance of the patients. QCT QCT is regarded as a secondary or adjunct tool to DXA. QCT may allow for monitoring BMD in premenopausal women and men between 20 to 50 years of age with risk factors. QCT demonstrates excellent precision and reproducibility to changes [31]. QUS There is insufficient evidence to support the use of QUS to monitor premenopausal women or adult men <50 years of age with risk factors. SXA There is insufficient evidence to support the use of SXA to monitor premenopausal women or adult men <50 years of age with risk factors. TBS There is insufficient evidence to support the use of TBS to monitor premenopausal women or adult men <50 years of age with risk factors. Variant 6: Males and females greater than or equal to 50 years of age. Suspected osteoporosis. Advanced degenerative changes of the spine with or without scoliosis, or other conditions that may spuriously elevate BMD. Initial imaging. DXA DXA allows for screening patients with risk factors and advanced degenerative changes in the spine. In a routine DXA examination, both the lumbar spine and hip are scanned and measured. Owing to the projectional nature of DXA, spuriously elevated BMD values of the lumbar spine may be caused by spondylosis and degenerative facet osteoarthritis or dense overlying tissue. Reportedly, in examinations with falsely elevated measurements, the most common cause (>81%) is degenerative disease of the spine [110]. The ISCD recommends close inspection of the images and associated BMD values to monitor levels for exclusion.