BMD Measurement Information
|< 50 years||Below expected range for age||Z-score ≤ -2.0|
|Within expected range for age||Z-score > -2.0|
|> 50 years||Severe (established osteoporosis)||T-score ≤ -2.5 with fragility fracture|
|Osteoporosis||T-score ≤ -2.5|
|Low bone mass||T-score -1.0 to -2.5|
|Normal||T-score ≥ -1.0|
bT-score: number of standard deviations above (+) or below (-) the mean peak density;
Z-score: number of standard deviations above (+) or below (-) the mean density for an individual of that age and sex.
cFracture Risk: (10-year absolute): low (<10%) moderate (10% to 20%), or high (>20%).
Fracture risk predicted for an individual by this system applies only for a finite period of time, and that risk will change with advancing age or with the development of new clinical risk factors. Based on 2010 CAROC system. Papaioannou, A et al. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 2010;182:1864-73.
dFor the purpose of second and subsequent testing (MOHLTC Schedule of Benefits, 2010)
“high risk patient” means a patient:
1. at risk for accelerated bone loss (in the absence of other risk factors, patient age is deemed not to place a patient at high risk for accelerated bone loss); or
2. with osteopenia or osteoporosis on any previous BMD testing, or
3. with bone loss in excess of 1% per year as demonstrated by previous BMD testing.
High risk patient is limited to a maximum of one test every 12 months unless the ordering physician obtains written prior authorization from a medical consultant.
“low risk patient” means a patient who is not a high risk patient. Limited to a maximum of one second test not earlier than 36 months following baseline; subsequent test not earlier than 60 months following the second or any subsequent test.
Recommended Timing of Follow-Up BMD Tests
|Expected Rate of BMD Change||Clinical Example||Timing of Follow-Up|
|Very High||Moderate to high dose glucocorticoids, anabolic agent||6 to 12 months|
|High||Osteoporosis drug therapy initiated or changed, low to moderate dose glucocorticoids||1 to 3 years|
|Moderate||Therapy with nutritional supplements or lifestyle improvements||1 to 3 years|
|Low||Stability documented on nutritional supplements or lifestyle improvements and with no change in clinical status; drug therapy shows to be effective||3 to 5 years|
|Very Low||Normal results or low fracture risk, and no clinical risks||5 to 10 years|
In some jurisdictions, the timing of follow-up may be restricted by provincial health insurance plans. In these circumstances, follow-up recommendations need to be applied in the context of local restrictions.
BMD Equipment Specifics
|Birchmount||GE Lunar||Prodigy Series||PA+130461|
|Coxwell||GE Lunar||Prodigy DPX||08/02/2066|
|Fanshawe||GE Lunar||Prodigy Advance||P8/PA+300482|
|Larch||GE Lunar||Prodigy Series||PA+301850|
|Milton||GE Lunar||Prodigy Advance||17/08/2726|
|Mississauga||GE Lunar||Prodigy Advance||PA+310220|
|North York||GE Lunar||Prodigy Series||8743/9055845PROD|
|Oshawa||GE Lunar||Prodigy Series||IRDF-85134|
|Pickering||GE Lunar||Prodigy Series||PA+15023|
|Simcoe||GE Lunar||Prodigy Series||LU43616EN|
|SSM||GE Lunar||Prodigy Advance||41191GR|
|Thornhill||GE Lunar||Prodigy Series||C00878-BMD-1|
|Wharncliffe||GE Lunar||Prodigy Advance||130476|
|Whitby||GE Lunar||Prodigy Series||IRDF-81159|