Posts Tagged ‘Dexa’
What determines “osteoporosis”? Is it DXA and BMD? Perhaps VFA and the lateral spine? What is the importance of Kyphosis? When is a collapsed vertebra a fracture? These are all questions for ISCD 2012.
The International Society for Clinical Densitometry meets this week at the 2012 annual meeting. As a society, we began by studying DXA as a tool to identify individuals at increased Risk of Fracture. We now realize that DXA and BMD are only part of the analysis. FRAX has been a major step forward. We will be sharing our observations and advancing our collective knowledge.
The researchers for the New England Journal of Medicine article about DXA counted only those few vertebral (spine) fractures that were recognized as fractures. Most vertebral fractures, especially in older women and in men, are mistaken for muscle pulls or arthritis.
Usually bones in the spine gradually crumble rather than suddenly crunch. These “silent” fractures count the same as (recognized) “clinical” fractures when calculating Future Fracture Risk and planning care. The researchers ignored this very important detail.
The New England Journal of Medicine has just published a study of DXA results. The researchers have interpreted the results as a reason to stop testing women with DXA. The study was only about DXA, and only about a special group of women who are unlike the vast majority of women.
DXA alone is a very poor way to test for “Clinical Osteoporosis” (High Risk of Fracture), especially in the women 67 and older who were the only ones studied. Even worse, the question asked in the study was how quickly the DXA score changed in the few women of that age who still have good DXA scores. That question is not even relevant to Fracture Risk.