• Preparation for a Bone Density Scan
• Download (here) and fill in our questionnaire and bring it with you
• Men, children and osteoporosis
• Bone strength quiz for women
• Bone strength quiz for men
• Links to more information

As part of our commitment to preventative health, we have long advocated bone density screening to identify those at risk for osteoporotic fractures. 

Since 1999, we have been using a DEXA (dual energy X-ray absorbiometry) machine that enables us to perform the recommended test for measuring bone mineral density (BMD).  

We are certified by the International Society for Clinical Densiometry to administer and interpret bone density scans, and to diagnose and treat osteoporosis.

DEXA is a painless and accurate way to monitor your bone density. 

Studies by the National Osteoporosis Foundation (NOF) found that BMD testing is cost effective for post-menopausal women aged 50-60 years old, with risk factors for osteoporosis and for women 60-65 years old without risk factors. 

In early menopause, bone loss occurs primarily from the spine.  In later years, the hip is the site of most bone  loss. 

DEXA measures both sites and the decision for treatment is based on the lowest measured value. 

RISK FACTORS

• History of fracture in near relatives
• Cigarette smoking
• Low body weight
• Anorexia or bulimia
• Early menopause (before 45 years)
• Prolonged, premenopausal amenorrhea (> 1 year)
• Low calcium intake / vitamin D deficiency (lifelong)
• Alcoholism
• Impaired eyesight despite adequate correction
• Recurrent falls
• Inadequate physical activity
• Use of prednisome or other steroid for more than 3 months

Results of DEXA bone density measurements are reported as a T-score. 

A T-score of 0 indicates a bone density similar to that found in a young (~30 year old), healthy population with peak bone mass. 

T-scores reflect deviation from this mean.  Each standard deviation reflects a change of 10-12%.  If your T-score is -1, you have 10-12% less bone density that the standard group, and an increased risk of fracture of ~1.5-fold. 

A T-score of between 0 and -1 is considered normal. 

A score of between -1 and -2.5 is termed osteopenia and signifies thin bones.  Some of the women with T-scores in the osteopenic range may have never achieved average peak bone mass. 

The World Health Organization (WHO) has defined osteoporosis as a T-score of -2.5.

The NOF recommends preventative treatment for women with T-scores of -1.5 and with risk factors for osteoporosis in addition to menopause.  If you have no additional risk factors, the NOF recommends preventative treatment if your T-score is less than -2.0.

All menopausal women should be getting at least 1200 mg of calcium per day, either from food or supplements, together with 400-800 IU of vitamin D. 

In addition, regular weight bearing exercise, avoiding tobacco and alcohol abuse are advised.

Your risk of fracture does not depend solely on bone density.  Fraility, falls, cigarette smoking, and a prior history of fracture are important factors that help decide whether treatment is advisable.  

For example, a woman who has had a vertebral fracture has a 5-fold increased risk of sustaining another vertebral fracture and twice the risk of hip fracture during the following year compared to a woman with the same BMD T-score who has not had a fracture.

Once a fracture has occurred, preventative measures to reduce the risk of subsequent fractures are therefore strongly recommended. 

Surgeon General’s Report:  On October 14, 2004, the Surgeon General’s office released a comprehensive report on osteoporosis.  According to this report, 1 million Americans over the age of 50 have osteoporosis, the most common bone disease, while another 34 million are at risk for developing it.  By 2020, 1 in 2 Americans over the age of 50 will be at risk for fractures from osteoporosis or low bone mass. 

The central focus of the report is to alert individuals and the medical community to the meaning and importance of bone health, including it’s impact on overall health and well-being, and the need to take action to prevent, assess and treat bone disease throughout life. The complete report can be viewed at http://www.surgeongeneral.gov.

Links to:

• Preparation for a Bone Density Scan & Questionnaire 
• Men and children and Osteoporosis

More information about bone mineral density and bone health can be found at

• International Society for Clinical densiometry
• National Osteoporosis FOundation
• American Society for Bone Mineral Research
• Menopause.org