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Friday, March 24, 2017

Bone Density Screening

Osteoporosis is a disease that results in low bone density and increased bone fragility with increased risk of fracture from falls or other trauma. Osteopenia precedes osteoporosis and reflects decreased rather than critically low bone density.  Bone density testing determines if you have osteopenia or osteoporosis, making it possible to know your risk of bone fractures before the fact and treating the condition if it exists. DEXA scanning is a hospital-based evaluation of the density of the lumbar spine and femurs, and is considered to be the “gold standard” of testing. Widespread osteoporosis testing and diagnosis is often limited by high cost and inconvenience.
Bone Density

At Parkway Family Physicians, we use an AccuDEXA portable bone densitometer to evaluate bone density in the hand to screen for overall bone density.  This is a cost-effective, low-radiation alternative to formal DEXA scanning shown to be positively and significantly correlated with hip bone density.  If osteoporosis is suggested, we follow up those results with a recommendation for formal DEXA scanning.

In addition to diagnosis, testing can also be used to monitor status of known osteopenia/ osteoporosis.  Current recommendations are to screen for bone density in postmenopausal women at age 65 and men at age 70. Younger men and women should also be tested if they have certain risk factors which include a fragility fracture, some chronic diseases such as rheumatoid arthritis and kidney disease, premature menopause, hormone treatment for prostate and breast cancers, significant loss of height, smoking history, family history of osteoporosis, regular use of corticosteroids, and significant alcohol use.

Based on the rates of transition from osteopenia to osteoporosis in four groups—normal BMD, mild, moderate, or severe osteopenia—researchers recommended that those whose initial tests show normal BMD or mild osteopenia can wait 15 years for follow up. Those with moderate osteopenia can wait five years, and those with advanced osteopenia should wait only one year between tests.
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