Posts Tagged ‘height loss’
Treat to Target of NO NEW FRACTURES. How do we find that target? DXA >-2.5 is a start. Fragility fractures increase new fracture risk. FRAX adds many more risk factors to the calculation and TBS refines FRAX.
Vertebral Fracture Assessment (VFA) looks at the spine from the side and independently identifies additional fracture risk. This can be done on a DXA machine or by x-ray. A single vertebral compression fracture of 25% or more pre-empts DXA, BMD, and FRAX in diagnosing Clinical Osteoporosis and recommending treatment.
VFA should be done because the majority of vertebral compression fractures are first noticed by x-ray or DXA VFA imaging. If you do not personally view the images, be sure the radiologist specifically checked for vertebral deformities as described by Genant.
I recently published my retrospective review of 1259 sequential first time VFA patients in Endocrine Practice 2017:23:1375-8.
VFA identified many patients not identified as high fracture risk (Clinical Osteoporosis) by DXA or fragility fracture or height loss or kyphosis or FRAX.
We should consider including VFA in every first time Complete Bone Health Evaluation.
And how should we treat? Next time…
Jay Ginther, MD
Fragility Fractures are fractures caused by osteoporosis. Fragility Fractures cost an enormous amount of money. They also cause pain, suffering, disability, nursing home stays, and death.
The estimated total cost of Fragility Fractures in the European Union for 2010 was 39 billion Euros. That is $52 billion US! Real money! That is a lot to pay for fractures that might have been prevented by screening and preventive treatment.
My Aunt Henrietta helped spark my interest in Osteoporosis Prevention and Treatment. She has experienced several complications of severe osteoporosis. She always looked after her neices and nephews. I have had the opportunity to return the favor. And I have been able to visit her this past week.
Visiting Henrietta reminds me of the problems that accompany severe osteoporosis. She can no longer see what is on a shelf much more than 4 feet from the floor. Reaching the upper half of closets is a huge challenge. Opening the upper pane of her windows required my assistance.