Comments: L3 and L4 are excluded due to scoliosis, anterior osteophytes and degenerative arthritis causing focal structural anomalies. Although L1 has a compression fracture and L2 is affected by osteoarthritis, we retain these vertebrae in the final T-score as valuable information on low bone mass is provided to the clinician. However, vertebrae affected by focal structural anomalies should be used with caution, if at all, when serial DXA measurements are performed to monitor a patient’s response to pharmacologic osteoporosis therapy.

AP