Measurement of bone density (bone mass) costs money and may involve exposure to radiation. It should only be measured when there are good indications to do so and if the results will influence the management of the patient.
Indications for measuring a patient's bone density:
(1) female >= 65 years of age
(2) male >= 70 years
(3) estrogen deficient female < 65 years with one or more lifestyle factors associated with osteoporosis (BMI < 21 kg per square meter, current smoker, family history of hip fracture)
(4) evidence of unexplained loss in height, kyphosis or vertebral fractures
(5) non-traumatic fracture after the age of 45 (or if risk factors for osteoporosis present)
(6) chronic disease associated with osteoporosis or osteomalacia (hyperparathyroidism, etc)
(7) long-term therapy with oral glucocorticoids (> 3 months) or other medications associated with osteoporosis
(8) prior to starting pharmacologic therapy for osteoporosis
(9) during therapy for osteoposis to monitor for response to therapy (must be measured at a site that is responsive to therapy)
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