USPSTF updates bone density screening guidelines

(a) Anteroposterior radiographs of both knee joints showing decreased bone density and trabeculations. (b) Follow-up radiograph at one year shows bone density has improved and trabeculations are less prominent. Image source: Indian J Orthop 2010 Oct–Dec; 44(4):453–457

The U.S. Preventive Services Task Force has revised its guidelines for bone density screening, broadening recommendations to include younger women.

The new guidelines, published Jan. 18 in the Archives of Internal Medicine, support screening for osteoporosis in women aged 65 years or older and in younger women whose fracture risk is equal to or greater than that of a 65 year old white woman with no additional risk factors.

According to the task force, 12 million Americans older than age 50 will have osteoporosis by 2012, with osteoporosis-related fractures affecting half of women with the diagnosis. Twenty-five percent of women with the disease develop vertebral deformity and 15 percent experience a hip fracture.

The guidelines referred to “convincing evidence that bone measurement tests predict short-term risk for osteoporotic fractures in women and men,” with dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine and quantitative ultrasonography of the calcaneus as the most commonly used tests.

The task force cited convincing evidence indicating drug therapies reduce fracture risk and that the benefit of treatment is at least moderate for women aged 65 years or older and younger women whose fracture risk is equal to or greater than that of a 65 year old white woman with no additional risk factors.