Table 3.

Indications for vertebral fracture assessment using x-ray absorptiometry [19]

1. Postmenopausal women with low bone mass (osteopenia) by BMD criteria plus one of the following:

- Age of greater than or equal to 70 years.

- Historical height loss of greater than 4 cm.

- Prospective height loss of greater than 2 cm.

- Self-reported prior vertebral fracture (not previously documented).

- Two or more of the following:

Age of 60 to 69 years.

Self-reported prior nonvertebral fracture.

Historical height loss of 2 to 4 cm.

Chronic systemic diseases associated with increased risk of vertebral fractures (for example, moderate to severe COPD, seropositive rheumatoid arthritis, and Crohn disease).

2. Men with low bone mass (osteopenia) by BMD criteria plus one of the following:

- Age of 80 years or older.

- Historical height loss of greater than 6 cm.

- Prospective height loss of greater than 3 cm.

- Self-reported vertebral fracture (not previously documented).

- Two or more of the following:

Age of 70 to 79 years.

Self-reported prior nonvertebral fracture.

Historical height loss of 3 to 6 cm.

On pharmacological androgen deprivation therapy or following orchiectomy.

Chronic systemic diseases associated with increased risk of vertebral fractures (for example, moderate to severe COPD, seropositive rheumatoid arthritis, and Crohn disease).

3. Women or men on chronic glucocorticoid therapy (equivalent to 5 mg or more of prednisone daily for 3 months or longer).

4. Postmenopausal women or men with osteoporosis by bone density criteria (total hip, femoral neck, or lumbar spine T score of not more than -2.5) if documentation of one or more vertebral fractures will alter clinical management.

BMD, bone mineral density; COPD, chronic obstructive pulmonary disease.