ACR Appropriateness Criteria(R) Osteoporosis and Bone Mineral Density
Department of Radiology
Osteoporosis is a considerable public health risk, with 50% of women and 20% of men > 50 years of age experiencing fracture, with mortality rates of 20% within the first year. Dual x-ray absorptiometry (DXA) is the primary diagnostic modality by which to screen women > 65 years of age and men > 70 years of age for osteoporosis. In postmenopausal women fracture, DXA is recommended. Some patients with bone mineral density above the threshold for treatment may qualify for treatment on the basis of vertebral body fractures detected through a vertebral fracture assessment scan, a lateral spine equivalent generated from a commercial DXA machine. Quantitative CT is useful in patients with advanced degenerative bony changes in their spines. New technologies such as trabecular bone score represent an emerging role for qualitative assessment of bone in clinical practice. It is critical that both radiologists and referring providers consider osteoporosis in their patients, thereby reducing substantial morbidity, mortality, and cost to the health care system. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Rights and Permissions
Citation: J Am Coll Radiol. 2017 May;14(5S):S189-S202. doi: 10.1016/j.jacr.2017.02.018. Link to article on publisher's site
AUC, Appropriate Use Criteria, Appropriateness Criteria, DXA, fracture, osteoporosis, screening
Ward, Robert J. and Baccei, Steven J., "ACR Appropriateness Criteria(R) Osteoporosis and Bone Mineral Density" (2017). Radiology Publications and Presentations. 325.