L - BONE HEALTH

In adults with SCI, total hip, distal femur, and proximal tibia bone density should be used to diagnose osteoporosis, predict lower extremity fracture risk, and monitor response to therapy where normative data are available. (Knee DXA Protocol: https://www.kite-uhn.com/clinical/tools/knee-dxa-protocol) (BMD 2019, p.4; Level B)

Serial DXA assessment of treatment effectiveness among individuals with SCI should include evaluation at the total hip, distal femur, and proximal tibia, following a minimum of 12 months of therapy at 1- to 2- year intervals. Segmental analysis of total hip, distal femur, and proximal tibia subregions from a whole-body scan should not be used for monitoring treatment. (BMD 2019 p.6; Level B)