A note on repeat bone density testing

BMD

new study published in The Journal of the American Medical Association (JAMA) looks at the usefulness of bone mineral density (BMD) testing and a repeated BMD test. BMD testing is done to help predict a person’s risk of future osteoporotic fractures. A good overview of the study can be found here. The study authors conclude that “a second BMD measure after 4 years did not meaningfully improve the prediction of hip or major osteoporotic fracture” in men and women (average age 75 years) who were not being treated for osteoporosis.

For people without osteoporosis (low risk of fractures), this is in accordance with current BMD testing guidelines in Ontario.

A bone density scan is important in predicting risk of fracture, but bone density alone cannot always tell which patients will fracture. There are several factors which affect a person’s risk for fracture; these are included in our quick fracture risk assessment test. Some factors can increase a person’s risk of fracture regardless of what their BMD shows — these include having had a previous osteoporosis-related fracture and taking glucocorticoid (steroid) pills for more than 3 months. For this reason, physicians and scientists from the Scientific Advisory Council of Osteoporosis Canada (chaired by our Program Director, Dr. Angela M. Cheung) recommend that a person’s 10-year-fracture risk, which takes BMD into account, should be used in diagnosing osteoporosis.

Based on this information, in Ontario, BMD testing for an individual who is not at risk for fractures or at low risk is done only once every 5 years. Only patients at high fracture risk are eligible for a BMD test once a year.

To learn more about the usefulness of bone mineral density testing or osteoporosis-related fractures, please view our Osteoporosis Information page.


Reference: Berry SD, Samelson EJ, Pencina MJ, et al. Repeat Bone Mineral Density Screening and Prediction of Hip and Major Osteoporotic Fracture. JAMA 2013;310(12):1256-1262. doi:10.1001/jama.2013.277817

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