Indications and reporting for dual-energy X-ray absorptiometry

Although dual-energy X-ray absorptiometry (DXA) is widely used to measure bone mineral density (BMD), there are few guidelines regarding indications for testing in populations other than postmenopausal women or for reporting the results from DXA studies. At the 2003 Position Development Conference of the International Society for Clinical Densitometry, positions were developed to formalize indications for bone density testing and the components of a DXA report. Bone density testing is indicated for the following individuals: women 65 yr of age and older, postmenopausal women under age 65 yr with risk factors, men 70 yr of age and older, adults with fragility fracture, adults taking a medication or adults with a disease or condition associated with low bone mass or bone loss, any individual being treated for low bone mass to monitor treatment effect, and any individual in whom evidence of bone loss would affect treatment decisions. The DXA report should include patient identification and demographics, identification of the referring provider, indications for the test, an explanation of the technique, and abnormalities in performing the study. In addition, the report should include BMD values, the T-score and/or Z-score as appropriate, World Health Organization (WHO) classification for diagnosis, risk factors, and recommendations for follow-up.