Solutions 2024
Total jbody jscan janalysis j- jANS✓✓-WHO jT-score jclassification jdoes jnot japply
cancellous jbone j(spongy jbone) j- jANS✓✓-Spine, jultradistal jradius, jcalcaneus
Lost jfirst jin jpost jmenopausal jwomen
cortical jbone j- jANS✓✓-compact jbone j— jfemoral jneck, j1/3 jradius, jtotal jbody j
Affected jfirst jby jhyperparathyroisism, jesp jwrist
Measurement jsites jin jkids j- jANS✓✓-4-16 jtotal jbody jor jbody jminus jhead
> j16 jhip j& jspine
Mixed jbone j- jANS✓✓-Total jhip, jtrochanter, jphalanges
Osteoporosis j- jANS✓✓-Fragility jfracture j(standing jheight jor jless)
Hip jfracture
Vertebral, jproximal jhumerus, jor jpelvis jfx j+ josteopenia j
Incidental jvertebral jfox
BMD j</= j-2.5
FRAX j>/= j3 jor j20
T-score j- jANS✓✓-BMD jpatient j- jBMD jyoung jnormal jmean jreference j/ jSD jyoung
jnormal jmean jreference
Z-score j- jANS✓✓-BMD jpatient j- jBMD jage jmatched jmean jreference j/ jSD jage
jmatched jmean jreference
Normal jBMD jchild j- jANS✓✓-Z-score j> j-2
T-score jcalculation jdatabase j- jANS✓✓-Hip: jNHANES jfemale jCaucasian j
Spine: jmanufacturer jfemale jCaucasian
Race jadjustment jand josteoporosis j- jANS✓✓-T-score jNO
Z-score jYES
Osteoporosis jin jkids j- jANS✓✓-Low jBMD jAND jfracture
Fractures: jvertebral, jsingle jLEs, jtwo jUEs
, Non jDXA jT-scores j- jANS✓✓-QCT jhip jand jfemoral jneck jonly jallowed
How jmuch jbone jstrength jis jpredicted jby jBMD? j- jANS✓✓-60-80%
absolute jrisk j- jANS✓✓-Number jof jpeople jwho jdevelop ja jdisease/number jof
jpeople jat jrisk
Relative jRisk j(RR) j- jANS✓✓-Ratio jof jabsolute jrisk jin j2 jgroups
Ex. jAbsolute jrisk jof jfracture jin jsmokers j/ jabsolute jrisk jin jnonsmokers j=
jrelative jrisk jof jfracture jin jsmokers
Risk jof jvertebral jfracture jfor jfuture jvertebral jfractures j- jANS✓✓-20% j1-3 jyrs
Risk jof jcontralateral jhip jfracture jafter jhip jfx j- jANS✓✓-29% jin j5 jyrs
5 jyear jrisk jof jfracture jafter jany jfx j- jANS✓✓-Forearm: j15% jmales, j20% jfemales
Vertebral: j18% jmales, j33% jfemales
Risk jfactors jfor jfracture jindependent jof jBMD j- jANS✓✓-Low jBMI
Prior jfx j
Family jh/o jhip jfx j
Current jsmoker
Steroids j(ever j— j5mg jper jday j> j3 jmonths)
EtOH j> j2
RA
FRAX jage j- jANS✓✓-40-90
NOF jcriteria jfor jusing jFRAX j- jANS✓✓-Untreated jpostmenopausal jwoman j(or
jman j> j50)
T-score j-1 jto j-2.5
No jprior jhip jor jvertebral jfx j
Evaluable jhip
'Untreated' jper jFRAX j- jANS✓✓-No jbisphosphonate jx j2 jyears j(up jto j2 jmos joral
jok)
No jother jtx jincl jcalcitonin, jSERM, jHR jx j1 jyear
FRAX jadjustment jfor jhip/spine jdiscordance j- jANS✓✓-For jevery jrounded jT-
score jdifference jof j1 junit, jadjust jrisk jof jmajor josteoporotic jfx jup jor jdown jby
j10%
ex. jFN jT-score j-1.5, jlS j-3.5
Increase jMOF jby j20% j(ex. jMOF jrisk jis j18%, jadd j3.6)
FRAX jadjustment jfor jsteroid jdose j- jANS✓✓-Low jdose j(<2.5mg): jMOF j-20%, jHip
j-35%