|Disease / Treatment||BMD assessment|
-no adequate dietary adherence
-other risk factors for fractures 
Difficult lumbar spine X-ray interpretation in cases of severe scoliosis.|
Total-body or distal femur DXA (area with higher fracture risk), only if there are fragility fractures .
|Duchenne muscular dystrophy||
Baseline DXA and annual monitoring.|
Lateral spine x-ray: Baseline
- On GCs treatment: Repeat every 1–2 years.
- Not on GCs treatment: Repeat every 2–3 years.
- If back pain or ≥ 0, 5 SD decline in spine BMD Z score on serial measurements over 12-month period: Repeat.
Refer to osteoporosis specialist following the first fracture .
|Rett syndrome||Baseline DXA, and serial controls according to individual risk .|
|Epilepsy||Consider DXA for epileptic patients receiving anti-epileptic drugs for a prolonged period |
|Thalassemia||DXA every 2 years from adolescence |
|Inflammatory/ systemic disease||Consider DXA for patients receiving high doses of GCs .|
|Juvenile idiopathic arthritis (JIA)||
< 6 years: DXA in the presence of fragility fractures.|
> 6 years: DXA if not presenting rapid remission of JIA or in need of high doses of GCs .
Baseline DXA two years after completing chemotherapy with osteotoxic drugs; e.g., MTX, GCs or hematopoietic cells transplantation; or secondary effects that favor osteoporosis development (growth hormone deficiency, hypogonadism, etc.)|
DXA follow-up based on the results of baseline DXA and persistent risk factors 
DXA in children ≥ age 8 if:|
- weight < 90% ideal weight
- FEV1 < 50%
- Delayed puberty
- High dosis of GCs > 90 days per year
At 18, all of them .
- low BMD specific risk factors
- increased daily insulin dosis
- impaired renal function
- fracture history 
|Anorexia nervosa||DXA in patients with amenorrhea for more than 6 months .|
|Systemic lupus erythematosus||DXA evaluation in patients with prolonged systemic GCs exposure exceeding ≥0.15 mg/kg daily for ≥ 3 months. Repeat on an annual basis if Z-score ≤ − 2 .|