title: Standards for performing DXA in individuals with secondary causes of osteoporosis.
abstract: This document addresses skeletal health assessment in individuals with secondary causes of osteoporosis. Recommendations are based on consensus of the Canadian Panel of the International Society for Clinical Densitometry and invited international experts. Bone mineral density (BMD) testing in these populations is performed in conjunction with careful evaluation of the disease state contributing to bone loss and increased fragility fracture risk, as well as assessment of other contributing risk factors for fracture. The presence of secondary causes of bone loss may further increase the risk of fracture independently of BMD and may necessitate earlier pharmacologic intervention. Dual-energy X-ray absorptiometry is indicated in the initial workup of secondary causes of osteoporosis. The BMD fracture risk relationship is not known for individuals with chronic renal failure (CRF). The BMD testing in this population may be normal in the presence of skeletal fragility, and quantitative bone histomorphometry is better at evaluating skeletal status than BMD in CRF. Dual-energy X-ray absorptiometry is a valuable tool in assessing skeletal health in individuals with secondary causes of osteoporosis.
authors.affiliation: Division of Endocrinology, McMaster University, Hamilton, Ontario, Canada, and Hanover General Hospital, PA, USA. avkhan@aol.com
authors.forename: Aliya A
authors.initials: AA
authors.lastname: Khan
authors.forename: David A
authors.initials: DA
authors.lastname: Hanley
authors.forename: John P
authors.initials: JP
authors.lastname: Bilezikian
authors.forename: Neil
authors.initials: N
authors.lastname: Binkley
authors.forename: Jacques P
authors.initials: JP
authors.lastname: Brown
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Hodsman
authors.forename: Robert G
authors.initials: RG
authors.lastname: Josse
authors.forename: David L
authors.initials: DL
authors.lastname: Kendler
authors.forename: E Michael
authors.initials: EM
authors.lastname: Lewiecki
authors.forename: Paul D
authors.initials: PD
authors.lastname: Miller
authors.forename: Wojciech P
authors.initials: WP
authors.lastname: Olszynski
authors.forename: Steven M
authors.initials: SM
authors.lastname: Petak
authors.forename: Zeba A
authors.initials: ZA
authors.lastname: Syed
authors.forename: Diane
authors.initials: D
authors.lastname: Theriault
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Watts
mesh_terms: D015502:Absorptiometry, Photon / Q000592:standards*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000453:epidemiology
chemical_list: D005938:Glucocorticoids