DETECTION

How to detect Osteoporosis?

Specialized tests called bone mineral density (BMD) tests can measure bone density in various sites of the body. A BMD test can:

  • Detect osteoporosis before a fracture occurs
  • Predict chances of fracturing in the future
  • Determine rate of bone loss and/or monitor the effects of treatment if a DEXA BMD test is conducted at intervals of one year or more

Medicare reimburses for BMD testing every two years.

A DEXA (Dual Emission X-ray Absorptiometry) scan of the spine and/or hip is most often used and is the best test to predict bone mineral density. A DEXA scan uses x-rays, but instead of creating a picture by exposing film, it uses a detector and a computer to calculate bone density. The test is painless and typically takes less than 10 minutes.

A screening test of the heel or wrist by ultrasound (for example, sometimes offered at health screening fairs) may also provide helpful information about bone density. You should discuss such results with your physician to determine if you need further evaluation.

Among several numbers produced from a DEXA scan, T-scores are most often used. A T-score compares your bone density to that of healthy young adult; -1 or greater is normal; -2.5 or lower is osteoporosis; and between -2.5 and -1 is considered osteopenia. Deciding when to treat depends on both an individual's T-score and risk.

Studies show that an increase in BMD testing and osteoporosis treatment is associated with a decrease in the incidence of hip fractures.

Bone density is an important determinant of fracture risk even in nursing home patients.

There has been a five-fold increase in office visits for osteoporosis in the past 10 years.

What are the Risk Factors?

Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis and fractures are called "risk factors." These risk factors include:

  • Personal history of fracture after age 50
  • Current low bone mass
  • History of fracture in a primary relative
  • Being female
  • Being thin and/or having a small frame
  • Advanced age
  • A family history of osteoporosis
  • Estrogen deficiency as a result of menopause, especially early or surgically induced
  • Abnormal absence of menstrual periods (amenorrhea)
  • Anorexia nervosa
  • Low lifetime calcium intake
  • Vitamin D deficiency
  • Use of certain medications (corticosteroids, chemotherapy, anticonvulsants and others)
  • Presence of certain chronic medical conditions
  • Low testosterone levels in men
  • An inactive lifestyle
  • Current cigarette smoking
  • Excessive use of alcohol
  • Kidney failure
  • Too little calcium in diet
  • intense exercise (such as marathon running), which reduces estrogen levels
  • Low body weight
  • Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

Women can lose up to 20 percent of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis.