Bone Density Scan (cont.)
Why is BMD measurement important?
Determining a
person's BMD helps a doctor decide if a person is at increased risk for
osteoporosis-related fracture. The purpose of BMD testing is to help predict the
risk of future fracture. The information from a BMD is used to aid a decision as
to whether prescription medicine therapy is needed to help reduce
the risk of fracture. Additionally, if a patient has a fracture or is planning orthopaedic surgery, a diagnosis of osteoporosis might affect the surgical plan. A fracture that could potentially heal in a cast with normal bone mass might require either a longer period of casting or even surgery if the patient has osteoporosis.
What is the relationship between BMD and fracture risk?
In patients with low bone mass at the hip or the spine (the two areas traditionally measured with DEXA scanning), there is a
two- to threefold increase in the incidence of any osteoporotic fracture. In other words, low bone density at the measured areas of the spine and hip can even predict future osteoporotic fractures at other parts of the body besides the spine and hip. In subjects with a BMD in the osteoporosis range, there is approximately a
five times increase in the occurrence of osteoporotic fractures.
Who should have BMD testing?
BMD testing is recommended for all women over the age of 65. Additionally, postmenopausal women under 65 years who have risk factors for osteoporosis other than menopause (these include a previous history of fractures, low body weight, cigarette smoking, and a family history of fractures) should be tested. Finally, men or women with strong risk factors as listed below should discuss the benefit of DEXA scanning with their doctor to see if testing is indicated.
The following are potential risk factors for osteoporosis that might suggest the need for DEXA
scanning:
- personal history of fracture as an adult,
- history of fracture in first-degree relative,
- low body weight or thin body stature,
- advanced age,
- current cigarette smoking,
- use of corticosteroid
therapy for more than three months,
- impaired vision,
- estrogen deficiency
at early age,
- dementia,
- poor health/frailty,
- recent falls,
- lifelong low calcium intake,
- low physical activity,
- alcohol intake of more than two drinks/day,
- thyroid disease,
- rheumatoid arthritis,
- excessive caffeine consumption, and
- use of oral contraceptive (birth control pills).
Next: How is BMD measured? »
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