The 1999 who and 2000 iof recommendations

The 1994 WHO Criteria did not direct physicians to measure bone density at a specific site for the diagnosis of osteoporosis. An interim report (5) from the WHO Task-Force for Osteoporosis was published in 1999 in which it was stated that DXA of the proximal femur was preferred for diagnostic bone density measurements, particularly in elderly individuals. Physicians were not directed in this report, however, to limit the application of the WHO Criteria for diagnosis to BMD measurements made at the proximal femur.

In 2000, the IOF (6) recommended that only bone density measured at the total femur be used for the diagnosis of osteoporosis based on the WHO Criteria. In 2002 however, the ISCD (7) stated that the WHO Criteria could be utilized with bone density measurements at the PA spine, total femur, femoral neck, or trochanter. They also stated that the WHO Criteria should not be applied to measurements of bone density made at any peripheral site (8). These positions strongly suggest that other skeletal sites, regardless of the technique by which they are measured, cannot be used for the diagnosis of osteoporosis.

The rationale behind these positions is both understandable and unfortunate and in no small way, reflects the confusion predicted by the WHO study group in 1994. Such positions also require that the identification of individuals at risk for fracture remain a separate issue from the diagnosis of osteoporosis because these positions would otherwise deny the established predictive ability of peripheral sites for fracture.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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