Monitoring
There is no firm evidence for how often dual-energy x-ray absorptiometry (DXA) should be repeated, either for primary screening or for monitoring treatment.[88] Studies in untreated older community-dwelling adults suggest that repeat bone mineral density (BMD) testing within 3-7 years provides no additional information for predicting fracture risk compared with baseline BMD alone.[218] Repeat BMD testing intervals should be individualized based on the patient’s overall risk of bone loss and fractures. For most patients, guidelines recommend waiting at least 2 years between DXAs to adequately assess change.[31][81]
The Endocrine Society recommends that postmenopausal women with a low BMD and at high risk of fractures who are being treated for osteoporosis have their BMD monitored by DXA at the spine and hip every 1 to 3 years to assess the response to treatment.[111]
Bone turnover markers can be used specifically in monitoring response to treatment.[83]
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