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Search tips. Browse by letter: A-Z. Searched for: Number of CPGs:. Sort by Relevance Publication Date. By using limited-term certifications, ISCD assures that certified individuals have met the ISCD competency criteria and continue to keep their skills up-to-date. This assures the public and the medical community that the certificant continues to provide quality professional care. You must provide documentation of 35 Category 1 CMEs in the field of bone densitometry, osteoporosis or metabolic bone disease.
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Women discontinuing estrogen should be considered for bone density testing according to the indications listed above. Application of recommendation may vary according to local requirements. In addition, if not recommended in the manufacturer protocol, the following QC procedures are advised:. Examples of technical differences amongst devices, fracture prediction ability for current manufacturers and equivalence study requirements are provided in the full text documents printed in the Journal of Clinical Densitometry.
Thank you to all participants and attendees at the Position Development Conference held in July as well as the hard work of the steering committee, panel members and work groups. Thank you to our conference supporters:. John P. Chair: John T. Co-Chair Elliott N.
Co-Chair: David M. Mary B. Fracture Prediction and Definition of Osteoporosis Subcommittee:. Chair: Nicholas J. Chair: Babette S. NOF believes more data are required in order to determine whether a single, female Caucasian reference database should be used for diagnostic T-score determinations in both genders or whether the male reference database is the preferred database for diagnostic purposes in men.
The Official Positions resulting from the PDC are intended to enhance quality and clinical utility of fracture risk assessment worldwide. Since the field of skeletal assessment is new and evolving rapidly, some clinically important issues addressed at the PDCs are not associated with robust medical evidence.
Diagnosis of Osteoporosis in Children and Adolescents
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Bone Health Assessment in Pediatrics - Guidelines for Clinical Practice | Ellen B Fung | Springer
Board Members Committees Staff Directory. Fracture Prediction and Definition of Osteoporosis Evaluation of bone health should identify children and adolescents who may benefit from interventions to decrease their elevated risk of a clinically significant fracture. The finding of one or more vertebral compression crush fractures is indicative of osteoporosis, in the absence of local disease or high-energy trauma. In such children and adolescents, measuring BMD adds to the overall assessment of bone health. The diagnosis of osteoporosis in children and adolescents should not be made on the basis of densitometric criteria alone.
A clinically significant fracture history is one or more of the following: 1 two or more long bone fractures by age 10 years; 2 three or more long bone fractures at any age up to age 19 years. In patients with primary bone disease, or at risk for secondary bone disease, a DXA should be performed when the patient may benefit from interventions to decrease their elevated risk of a clinically significant fracture, and the DXA results will influence that management.
DXA should not be performed if safe and appropriate positioning of the child cannot be assured. Other sites may be useful depending on the clinical need. Soft tissue measures in conjunction with whole body scans may be helpful in evaluating patients with chronic conditions associated with malnutrition or with muscle and skeletal deficits. Proximal femur DXA measurements can be used, if reference data are available, for assessing children with reduced weight bearing and mechanical loading of the lower extremities or in children at-risk for bone fragility who would benefit from continuity of DXA measurements through the transition into adulthood.
Lateral distal femur LDF DXA measurements, if reference data are available, correlate well with increased lower extremity fragility fracture risk in non-ambulatory children. LDF DXA can: Assess BMD in children when the presence of non-removable artifacts orthopedic hardware, tubes , positioning difficulties, abnormal skeletal morphometry, or severe scoliosis with torsion interfere with DXA acquisition at other anatomical sites.
Monitor the effects of changes of weight-bearing in non-ambulatory children. Following VFA, additional spine imaging should be considered in the following circumstances: Vertebrae that are technically un-evaluable by VFA i. They can be used clinically in children where appropriate reference data and expertise are available. It is imperative that QCT protocols in children using general CT scanners use appropriate exposure factors, calibration phantoms, and software to optimize results and minimize radiation exposure.
Densitometry in Infants and Young Children DXA is an appropriate method for clinical densitometry of infants and young children. Areal BMD should not be utilized routinely due to difficulty inappropriate positioning. Forearm and femur measurements are technically feasible in infants and young children, but there is insufficient information regarding methodology, reproducibility, and reference data for these measurements sites to be clinically useful at this time.
In infants and children below 5 years of age, the impact of growth delay on the interpretation of the DXA results should be considered, but it is not quantifiable presently. In patients with primary bone disease, or at risk for a secondary bone disease, a DXA should be performed when the patient may benefit from interventions to decrease their elevated risk of a clinically significant fracture, and the DXA results will influence that management.
The hip is not a preferred measurement site in growing children due to variability in skeletal development. Additionally, indications for follow-up scan; technical comparability of studies; changes in height and weight; and change in BMC and areal BMD Z-scores should be reported. It is imperative that QCT protocols in children using general CT scanners use appropriate exposure factors, calibration phantoms and software to optimize results and minimize radiation exposure.
Areal BMD should not be utilized routinely due to difficulty in appropriate positioning. Forearm and femur measurements are technically feasible in infants and young children, but there is insufficient information regarding methodology, reproducibility and reference data for these measurements sites to be clinically useful at this time.
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