Archive for the ‘Evaluation and Screening’ Category

Not Just DXA – Fracture Risk !!

February 22, 2015 @ 9:39 pm
posted by Dr Ginther

DXA is very good at determining Bone Mineral Density (BMD), provided you look at the images and over-read the computer.  DXA alone is less good at predicting Fracture Risk.  But, Fractures are what we want to avoid.

At the International Society for Clinical Densitometry (ISCD) meeting this week, we will discuss the other modalities, which supplement DXA to obtain greater accuracy.  Vertebral Fracture Assessment (VFA) helps evaluate bone quality.  FRAX was specifically designed to predict Fracture Risk.  QCT (Quantitative Computerized Tomography) has been added in recent years as an alternative to DXA.

ISCD will discuss adding  TBS (Trabecular Bone Score), Hip Structural Analysis, Hip Axis Length, and uses of Central CT.  We are constantly pushing toward our goal – Prevent Fractures.

Preventing Fractures is not just DXA.  Get a Complete Bone Health Evaluation.

Take Control of your future.  Check your bone health.

Jay Ginther, MD

Not Me !!!

January 31, 2015 @ 11:22 pm
posted by Dr Ginther

I often hear: “I do not have osteoporosis, but my friend…”  How are you certain that you do not have a bone health issue that could be improved upon?  By the simple belief of “not me !!!”  This I understand all too well after doing the same.

In bone health, the first sign of trouble is often a fracture, possibly a hip fracture, with a 20-30% chance of death.  This is not good.  In heart health, a rhythm problem, can lead to “V fib”, which often leads to death within minutes, unless you get to a defibrillator.  Also not good.

I now have a new 2-lead pacemaker with defibrilator.  I was completely unaware that my heart had become a ticking time bomb.  I was lucky to have a routine annual heart check-up scheduled.  Otherwise, my first warning could have been “V fib” with sudden death.  Really not good.

Once I realized I had a problem, I moved quickly to the solution – pacemeker defibrillator.  I wasted no time.  Now I am able to do all the things I want to – travel, grandchildren, etc.

You do not need to be as clueless as I was.  Take Control of your health. Check on your risks for diabetes, high blood pressure, heart disease, and bone health.  Then take action to correct problems.  Get a Complete Bone Health Evaluation as well as evaluation of the rest of your body.

Jay Ginther, MD

Fractures are NOT FUN.  Not something you want to repeat.  Any fracture is a Bone Attack.  It is a warning that you probably have Bone Health issues that can be improved.  Get a Complete Bone Health Evaluation and work to prevent a second fracture.  Most people can succeed in preventing that second fracture.

I see many individuals who have had a first fracture.  Often the DXA, BMD, and T-score are not that bad.  I even see many who have good DXA test scores.  But they still fractured with relatively minor trauma.  They proved that they have increased Fracture Risk.  Why?

The American Society of Clinical Oncology received bad news about Breast Cancer Patients this week.  A study of women with breast cancer, being treated with Aromatase Inhibitors (AI), was presented at the 2014 Breast Cancer Symposium.  AI is a great treatment for breast cancer, however…

AI is known to decrease bone strength and to increase Fracture Risk.  How many of these patients  were evaluated for their bone health?  Only 54%.  How many got a repeat evaluation to check to be sure that their bone health was not deteriorating?  Only 46%.

Of those tested, 43% had a DXA T-score in the “osteopenia” range.  In this situation, FRAX is needed to calculate Fracture Risk.  41% of this group met guidelines for treatment with medication to prevent bone loss and Fractures.  Of those who should have been treated, only 23% were.