Posts Tagged ‘Bone Density’
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
Wrong Question! What you should be managing is Fracture Risk. If you only look at Bone Mineral Density (BMD), you miss the chance to decrease Fracture Risk in the overwhelming majority of people.
85% of the women who Fracture have a DXA score of “osteopenia” or even “normal”. Keeping their bone density at “only osteopenia” does them no favor. So how can you manage Fracture Risk?
I recently saw a patient who has not improved her Bone Mineral Density despite 2 years of Forteo followed by 3 years of Reclast. The good news is that she stopped having Fragility Fractures. But she is very disappointed that her BMD has not improved.
Her problem is obvious. She is willing to take high-powered osteoporosis medications. She is not willing to take Calcium either in her diet or in supplements.
WRONG!!!! 85% of women who suffer Fragility Fractures have “Osteopenia”. Close to 90% of men. How can this be? “Osteopenia” is NOT a Diagnosis. Unfortunately, most people do not understand that “Osteopenia” is not a Diagnosis.
Fracture Risk is not just DXA t-score or Bone Mineral Density (BMD). “Osteopenia” is a BMD t-score of minus 1.1 through minus 2.4. Increased Fracture Risk (the NIH definition of Osteoporosis) starts at minus 2.5 at age 60, but Increased Fracture Risk starts at minus 1.3 at age 80. And that is only if there are no other Risk Factors, such as previous fracture, parent with a hip fracture, smoking, inhalers, etc.