Posts Tagged ‘VFA’
I have let the regular posts to the blog lapse for quite some time, while working on other issues.
I have been reviewing my first-time Vertebral Fracture Assessment (VFA) patients. My latest research project included 1259 patients over 3 1/2 years. I analyzed the patients by FRAX, height loss, age, and fragility fractures as well. Nothing duplicated the findings by VFA.
I found that DXA alone missed many patients who have Clinical Osteoporosis if VFA (lateral spine) is taken into account. I have presented this at ISCD and ASBMR. Putting it into proper format to submit for publication took much more time than I anticipated.
This project is finished until I start the next sub-analysis.
I hope to get back to adding to the blog regularly.
Jay Ginther, MD
Ann spends a week in Florida each winter with several friends and was stronger, more agile and more confident this year than last. She stepped in and out of the hot-tub easily instead of slowly and awkwardly. She zoomed up and down stairs. She had to slow down when walking with her friends. What has happened?
A year ago she followed a fragility fracture with below average and decreasing BMD on DXA, and a newly crumbling vertebral fracture on VFA. She has Clinical Osteoporosis. That got her attention. She was determined to play on the floor with her active preschool grandchildren. You cannot do that if you are crumbling. She was ready to do whatever it took to get back in the game.
She added Adora Chocolates (500mg calcium in each) to her usual diet. She added Protein shakes (chocolate) and increased intake of chicken, fish, and beef to meet the new protein guidelines. She remembered to take extra Vitamin D3 and her Multiple Vitamins & Minerals almost every day.
She got serious about her “10,000 steps” every day and went up and down stairs frequently instead of saving up things for a single trip. She did not actually join an exercise class as promised.
She started the anabolic, Forteo, to build her bone density and strength. A daily little shot is a nuisance, especially keeping it cold while travelling, but she wanted results.
This year repeat DXA showed increased BMD. VFA confirmed no further crumbling. She zoomed through airports and left her friends in the dust in Florida. These results have made her even more determined.
She has Taken Control of her Future Life. You can too.
Jay Ginther, MD
Driving to Chicago in February was cold and snowing. But it was hot indoors at the ISCD (International Society for Clinical Densitometry) Annual Meeting and Position Development Conference (PDC).
While no new technologies were introduced, the PDC evaluated the scientific studies of several recent innovations. Most are best done in research centers. One recent innovation could make it to clinical centers. Trabecular Bone Score (TBS) is a software addition to DXA that adds information about the quality of bone by re-analyzing the L1, L2, L3 vertebrae.
We have discussed how adding Vertebral Fracture Assessment (VFA) to a DXA Bone Mineral Density (BMD) improves Fracture Risk calculation. TBS has the same potential. The main issues blocking TBS are software cost, added time, and the fact that all insurances (including Medicare) currently do not pay for it.
We also attended presentations about patient treatment issues. Fracture Prevention is much more than just checking a T-score with DXA. National experts shared their knowledge of medical issues that can strongly influence Bone Health and Fracture Risk. More about these sessions next time.
You can Take Control of your Future with action to decrease your fracture risk.
Jay Ginther, MD
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