Clinical indications for dxa scan

Clinical Indications for DXA Scan
Based on the Irish Osteoporosis Guidelines for Health Professionals and The American College of Radiology 2008 Contraindications (reasons against) for performing DXA:
Recently had gastrointestinal contrast or radionuclides Severe degenerative changes or fracture deformity in the measurement area Inability to attain the correct position and/or remain motionless for the Extreme obesity or extremely low body mass index that may inversely affect the technique and the ability to obtain accurate and precise measurements
Criteria for having a DXA scan

Group 1:
All women 65 years of age and older All men age 70 years and older (asymptomatic screening) Women under age 65 with additional risk for osteoporosis. o Women discontinuing oestrogen or oestrogen deficiency (peri- o Early or premature menopause (before age 45 years old) o History of amenorrhoea (no periods) for more than 1 year under the o History of maternal hip fracture that occurred after the age of 50 years o Eating disorders (current/past) o Men younger than 70 with hypogonadism/ testosterone deficiency o Adults of any age with fragility fractures o Men or women receiving or expected to receive steroid treatment for more than 3months (e.g. >5mg Prednisolone for more than 3 months in a year) o Individuals beginning or receiving long-term therapy with medication known to adversely affect bone mineral density:  Anti- coagulants - warfarin, heparin  Anti-epileptics - Epinutin  Aromatase inhibitors etc (refer to next page for list of medications that may cause osteoporosis) o Individuals of any age with radiologic evidence of:  low bone mass (osteopenia),  vertebral deformity (kyphosis)  the presence of vertebral compression fractures. o Men and women any age with a disease associated with defect in bone development, low bone mass or bone loss such as:  osteogenesis imperfect  Hyperthyroidism (overactive thyroid gland)  inflammatory bowel disease (IBD).  Rheumatoid arthritis  growth hormone deficiency o Men and women of any age who have the following risk factors;  have experienced a loss of height by more than 2cm  have had a low BMI (less than 18kg/m2)  have experienced severe malnutrition or poor nutrition  have an excessive alcohol intake (>14 units a week for women  have been or currently are smokers  have a history of taking excessive exercise, particularly with Chemotherapy Radiation Thyroxine (Eltroxin), if serum levels are high Anticonvulsant therapy or anti- epileptic medications (phenytoin and phenobarbitone)- interfere with calcium absorption and production of Vit. D. Chronic heparin or Warfarin therapy Long term lithium therapy GnRh analogues LHRH analogues; testosterone suppression Prolactin raising drugs such as antipsychotic medications e.g. some SSRI, Aromatase inhibitors for the treatment of Prostatic and Breast Cancers e.g. Diuretics such as Burinex and Lasix (ferusemide) Proton Pump Inhibitors


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