As a busy clinician it is hard to keep up sometimes. Here are some of the new guidelines for osteoporosis screening. For our physicians caring for younger patients, remind them to get in their calcium! The body needs calcium at all ages but more when they are young and growing. The recommendation for dairy is 3-4 servings a day. If your patients get their calcium in other ways, they have to work a little harder to get it in. How many of us are getting in what we need everyday to keep our bones strong?
New recommendations from the 2018 USPSTF regarding Osteoporosis
All women aged 65 and older should have osteoporosis screening with bone measurement testing. The USPSTF found convincing evidence that bone measurement tests accurately detect osteoporosis and predict osteoporotic fractures.
Women younger than 65 should be screened if they have the following risk factors as the benefit of treatment in preventing fractures is moderate:
- parental history of hip fracture
- excessive alcohol consumption
- low body weight
- long-term corticosteroid use
- previous fractures
- falls in the last year
Men should not be screened routinely unless they have additional risk factors.
Bone measurement techniques have varying degrees of accuracy and central DXA scanning is the established standard for diagnosing osteoporosis and guiding treatment decisions.
The peripheral DXA may increase access to osteoporosis screening but scanning at the calcaneus may be less accurate vs central DXA scanning.
The harms associated with osteoporosis medications is small and the serious adverse events associated with bisphosphonates, the most commonly used osteoporosis medications, include upper gastrointestinal and cardiovascular events.
US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for osteoporosis to prevent fractures: US preventive services task force recommendation statement. JAMA. 2018;319:2521-2531.