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Get a Complete Bone Health Evaluation

February 29, 2012 @ 7:30 pm
posted by Dr Ginther

“When should I get another DXA?”  That was the question from a 70+ year old at the PEO group I talked to recently.  That is the wrong question!

Don’t get just a DXA. DXA alone misses 85% of Fracture Risk, especially in older individuals.  What you should get is a Complete Bone Health Evaluation.  That allows you to catch problems early enough to “Take Control Naturally” with Calcium Citrate, enough Vitamin D, and exercises.  But what is a Complete Bone Health Evaluation?

DXA read by an ISCD Certified Clinical Densitometrist is a start.  ISCD certification assures proper readings.

Vertebral Fracture Assessment (VFA) picks up those patients whose spine is quietly, slowly crumbling.  Most vertebral crumbles are “silent”.

FRAX calculation reveals Fracture Risk far more accurately than DXA and Bone Mineral Density.

Blood tests are not just the CBC and Complete Metabolic Profile routinely done for annual check-ups.  You also need a 25-hydroxy Vitamin D level, PTH and TSH.

Focused history and physical examination focused on bone health complete the first 5 steps.

The last step is key.  You need to spend 20-30 minutes strictly on bone health, fracture prevention, and osteoporosis prevention or treatment.  Geisinger Health System in PA demonstrated years ago that their primary care docs did a great job managing bone health, but only when bone health was the only topic covered in the office visit.

Jay Ginther, MD

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