Osteoporosis International

, Volume 16, Issue 5, pp 456–459 | Cite as

The perspective of the International Osteoporosis Foundation on the official positions of the International Society for Clinical Densitometry

  • John A. KanisEmail author
  • Ego Seeman
  • Olof Johnell
  • Rene Rizzoli
  • Pierre Delmas
Position Paper


The International Society for Clinical Densitometry (ISCD) has published position statements on topics relating to the use and interpretation of measurements of bone mineral density (BMD). The most recent appeared in the Journal of Clinical Densitometry [1] and was republished in the Journal of Endocrinology and Metabolism and in Osteoporosis International [2, 3]. The topics included the indications for testing with BMD, the use of central dual energy X-ray absorptiometry (DXA) for the diagnosis of osteoporosis, the use of the Z-score and some recommendations for the spelling of the T-score and Z-score. Although these topics were chosen in an attempt to produce international consistency and consensus, most of the position statements lack a scientific basis.

Indications for bone density testing

The ISCD recommends that BMD testing be undertaken in all women aged 65 years or more and in all men aged 70 years or more. In adult men and postmenopausal women below this threshold...


Bone Mineral Density Osteoporosis Lumbar Spine Femoral Neck Fracture Risk 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Lieb E, Lewiecki EM, Binkley N, Hamdy RC (2004) Official positions of the International Society for Clinical Densitometry. J Clin Densitometry 7:1–5Google Scholar
  2. 2.
    Lewiecki EM, Watts NB, McClung MR, et al for the International Society for Clinical Densitometry (2004) Official position of the International Society for Clinical Densitometry. J Clin Endocrinol Metab 89:3651–3655CrossRefPubMedGoogle Scholar
  3. 3.
    Lewiecki EM, Kandler DL, Kiebzak GM, Schmeer P, Prince RL, El Hajj Fuleihan G, Hans D (2004) Special report on the official positions of the International Society for Clinical Densitometry. Osteoporos Int 15:779–784Google Scholar
  4. 4.
    Writing Group for the ISCD Position Development Conference (2004) Indications and reporting for dual energy X-ray absorptiometry. J Clin Densitometry 7:37–44Google Scholar
  5. 5.
    National Osteoporosis Foundation (2003) Physicians’ guide to prevention and treatment of osteoporosis. NOF, Washington DCGoogle Scholar
  6. 6.
    US Preventive Services Task Force (2002) Screening for osteoporosis in postmenopausal women: recommendations and rationale. Ann Intern Med 137:526–528PubMedGoogle Scholar
  7. 7.
    European Community (1998) Report on osteoporosis in the European Community. EC, StrasbourgGoogle Scholar
  8. 8.
    World Health Organisation (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843. WHO, GenevaGoogle Scholar
  9. 9.
    Royal College of Physicians (1999) Osteoporosis: clinical guidelines for the prevention and treatment. RCP, LondonGoogle Scholar
  10. 10.
    Pitt FA, Lloyd-Jones M, Brazier JE, McGrother CW, Kanis JA, Wallace WA, et al (1990) The costs and benefits of screening for and preventing osteoporosis in Trent Region: a report of the Trent Regional Osteoporosis Working Party. Trent Health, UKGoogle Scholar
  11. 11.
    Hailey D, Sampietro-Colon L, Marshall D, Rico R, Granados A, Ausna J, Sheldon T (1996) INAHTA project on the effectiveness of bone density measurement and associated treatments for prevention of fractures. International Network of Agencies for Health Technology Assessment. Alberta Heritage Foundation for Medical Research, Edmonton, AlbertaGoogle Scholar
  12. 12.
    Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Br Med J 312:1254–1259Google Scholar
  13. 13.
    Stone KL, Seeley DG, Lui LY, et al (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the study of osteoporotic fractures. J Bone Miner Res 18:1947–1954PubMedGoogle Scholar
  14. 14.
    Siris E, Miller P, Barrett-Connor E, Faulkner K, Welvien L, Abbot T, Berger M, Santora A, Sherwood L (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822CrossRefPubMedGoogle Scholar
  15. 15.
    Schnit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone density in elderly men and women: the Rotterdam Study. Bone 34:195–202CrossRefPubMedGoogle Scholar
  16. 16.
    Rose G (1992) The strategy of preventive medicine. Chapter 4. Prevention for individuals and the ‘high’ risk strategy. Oxford University Press, London, pp 29–52Google Scholar
  17. 17.
    Kanis JA, Johnell O, Oden A, De Laet C, Jonsson B, Dawson A (2002) Ten year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30:251–258CrossRefPubMedGoogle Scholar
  18. 18.
    World Health Organization (2004) World health report: changing history. WHO, GenevaGoogle Scholar
  19. 19.
    Melton LJ III, Johnell O, Lau E, Mautalen CA, Seeman E (2004) Osteoporosis and the global competition for health care resources. J Bone Miner Res 19:1055–1058Google Scholar
  20. 20.
    Bacon WE, Maggi S, Looker A, Harris T, Navi CR, Giaconi J, et al (1996) International comparison of hip fracture rates in 1988–1989. Osteoporos Int 6; 69–75Google Scholar
  21. 21.
    Ellfors L, Allander E. Kanis JA et al (1994) The variable incidence of hip fracture in Southern Europe, the MEDOS Study. Osteoporos Int 4:253–263PubMedGoogle Scholar
  22. 22.
    Johnell O, Gullberg B, Allander E, Kanis JA (1992) The apparent incidence of hip fracture in Europe: A study of national register sources. MEDOS Study Group. Osteoporos Int 2:298–302PubMedGoogle Scholar
  23. 23.
    Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities. Implications for risk assessment. J Bone Miner Res 17:1237–1244PubMedGoogle Scholar
  24. 24.
    Kanis JA, Black D, Cooper C, Dargent P, Dawson-Hughes B, De Laet C, et al (2002) A new approach to the development of assessment guidelines for osteoporosis. Osteoporosis Int 13:527–536CrossRefGoogle Scholar
  25. 25.
    Kanis JA, Glüer CC for the Committee of Scientific Advisors, International Osteoporosis Foundation (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporosis Int 11:192–202CrossRefGoogle Scholar
  26. 26.
    Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas PD, et al (2004) Predictive value of bone mineral density for hip and other fractures. J Bone Miner Res (in press)Google Scholar
  27. 27.
    Looker AC, Orwoll ES, Johnston CC, Lindsay RL, Wahner HW, Dunn WL, et al (1997) Prevalence of low femoral bone density in older US adults from NHANES III. J Bone Miner Res 12:1761–1768PubMedGoogle Scholar
  28. 28.
    Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–486CrossRefPubMedGoogle Scholar
  29. 29.
    Kanis JA, Johnell O, Oden A, Johansson H, Eisman JA, Fujiwara S, Kroger H, Melton III LJ, O’Neill T, Reeve J, Silman A, Tenenhouse A (in press) Why measure femoral neck and lumbar spine BMD for diagnosing osteoporosis. Osteoporos IntGoogle Scholar
  30. 30.
    Blake GM, Patel R, Knapp KM, Fogelman I (2003) Does the combination of two BMD measurements improve fracture discrimination? J Bone Miner Res 18:1955–1963PubMedGoogle Scholar
  31. 31.
    Kanis JA, Barton I, Johnell O (2004) Risedronate decreases fracture risk in patients selected solely on the basis of prior vertebral fracture. Osteoporos Int (in press)Google Scholar
  32. 32.
    Wasnich RD, Davis JW, Ross PD (1994) Spine fracture risk is predicted by non spine fractures. Osteoporos Int 4:1–5Google Scholar
  33. 33.
    Lunt M, Felsenberg D, Reeve J, Benevolenskaya L, Cannata J, Dequeker J (1997b) Bone density variation and its effects on risk of vertebral deformity in men and women studied in 13 European centres: The EVOS study. J Bone Miner Res 12:1883–1894PubMedGoogle Scholar
  34. 34.
    DeLaet CEDH, Van Hout BA, Burger H, Hofman A, Weel AEAM, Pols HAP (1998) Hip fracture prediction in elderly men and women: validation in the Rotterdam Study. J Bone Miner Res 13:1587–1593PubMedGoogle Scholar
  35. 35.
    Kanis JA, Johnell O, Oden A, De Laet C, Mellstrom D (2001) Diagnosis of osteoporosis and fracture threshold in men. Calcified Tissue Int 69:218–221Google Scholar
  36. 36.
    Hui SL, Slemenda CW, Johnston CC (1998) Age and bone mass predictors of fracture in a prospective study. J Clin Invest 81:1804–1809Google Scholar
  37. 37.
    Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B (2001) Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporosis Int 12:989–995Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • John A. Kanis
    • 1
    Email author
  • Ego Seeman
    • 2
  • Olof Johnell
    • 3
  • Rene Rizzoli
    • 4
  • Pierre Delmas
    • 5
  1. 1.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK
  2. 2.Endocrine UnitAustin Hospital, University of MelbourneMelbourneAustra;ia
  3. 3.Department of OrthopaedicsMalmo General HospitalMalmoSweden
  4. 4.Department of Internal MedicineUniversity HospitalGenevaSwitzerland
  5. 5.INSERM Research Unit 403Hopital Edouard HerriotLyonFrance

Personalised recommendations