Posts Tagged ‘VFA’

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

You Don’t Have To Fall To Break A Hip

December 4, 2014 @ 7:29 pm
posted by Dr Ginther

Sometimes a person breaks a hip first, then they fall.  This happens a lot more often than we realize.  When the break is just below the ball of the hip, the fracture may have come before the fall.  Moreover, that Fragility Fracture may have gradually developed over days or weeks.

How is it possible that a person does not realize that the hip is gradually crumbling?  We call it a Stress Fracture when a crack gradually developes.  Small cracks gradually getting bigger are usually not recognized until they are completely across the bone and it breaks, causing the patient to fall.  Why?

The aching pain of a stress fracture is often too gradual to distinguish from arthritis pain until the break is complete and the whole bone collapses.  The best way to see this process is to watch a video of the I-35W bridge collapsing in Minneapolis on 1st August 2007.  http://search.yahoo.com/search?ei=utf-8&fr=aaplw&p=i35w+collapse   Tiny cracks slowly developed in the steel until one day……..THUD!

How can you detect who is at high Hip Fracture Risk?  A very low DXA T-score, especially in the spine, is a good indication.  But DXA often fails if the spine is already crumbling or has arthritis.  A better indication is Vertebral Fracture Assessment (VFA).  Looking at the spine from the side, Vertebral Compression Deformities can indicate crumbling spongy bone in the spine before the spongy bone in the hip also crumbles.

Know where you stand.  Get a Complete Bone Health Evaluation.  Take Control of your future.

Jay Ginther, MD

How Hard Is It To Manage Bone Density?

November 23, 2014 @ 7:57 pm
posted by Dr Ginther

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?

Forteo is a daily shot.  That is a nuicence, but a small price to pay for the only Anabolic, the only osteoporosis medication which will increase bone mass in spongy (cancellous) bone.  Diabetics give themselves a daily shot for the rest of their lives.  Forteo is for only 2 years and uses a tiny insulin needle. 

People worry about the warning that lab rats got Osteosarcoma after being given very high doses of Teriparatide for the equivalent of 70 human years.  We have not seen this in humans, or chimps, or monkeys, or dogs.  Rats have bones that grow all their lives.  We do not give Forteo to growing humans, pregnant women, nursing women, persons with Paget’s Disease or unexplained elevated Alkaline Phosphatase, or persons who have had radiation to their bones.

Remember that you must take adequate Calcium, with food, spread out over 3 meals. You must take enough Vitamin D3 to be able to absorb Calcium.  You must eat enough Protein for your OsteoBlasts to make new bone matrix.