Are You Dense?

When it comes to bone health, you should be.

As one of two bone density technologists at the Baylor Breast Center at Baylor Medical Center at Garland, Judith Wendel, RRT, measures the bone mineral density (BMD) of a variety of patients, mostly women over 50. Noninvasive, fast and painless, a bone mineral density test, sometimes called a DEXA scan (dual energy X-ray absorptiometry), is the most accurate way to determine bone health. BMD tests can identify osteoporosis, determine the risk for fractures and track a patient’s response to osteoporosis treatment.

“We always scan in two places, usually the lumbar spine and one hip because these are the most important locations for osteoporosis-related fractures,” Wendel says.

Enhanced Technology
The Baylor Breast Center recently installed a new bone densitometry unit called the Hologic^® Discovery QDR. This new machine provides a faster, more accurate test, generating higher-resolution images with a smaller radiation dose to the patient. Its sophisticated software package conducts computer-aided fracture assessment, including a special Instant Vertebral Assessment (IVA) that pinpoints the presence of tiny compression fractures in the vertebrae.

“Another benefit of the machine is that it can track a patient’s bone density over time,” Wendel says. It will compare the results of a follow-up scan to a baseline scan to help the physician determine, for example, whether calcium supplements are helping to maintain the patient’s bone density, or, in case of continued bone loss, whether it’s time to prescribe an osteoporosis medication.

What the Numbers Mean
The result of a bone density test, called a T score, indicates the standard deviation from normal bone density. If your bone density is higher than normal for your age group, you’ll have a positive T score. Negative T scores indicate varying degrees of bone loss, beginning with osteopenia, or “pre-osteoporosis,” which signals the potential for further bone loss if not treated.

+1.0 TO +4.0	ABOVE NORMAL
0.0	NORMAL
-1.0 TO -2.5	OSTEOPENIA
-2.5 TO LOWER	OSTEOPOROSIS

When Wendel tests her patients, she conducts a thorough medical and lifestyle assessment touching on all the osteoporosis risk factors. “I also ask about any previous fractures from low-impact activities, such as stepping off a curb or even sneezing. Those are flags for low bone density.”

She pays particular attention to her Asian patients, both men and women. “Asians of both sexes are often petite and small-boned, and they typically are not milk drinkers. Asian women are also less likely to be taking hormone replacement,” she says.

Many people don’t realize that osteoporosis is associated with long-term disability and premature death. “About 25 percent of women over age 50 who fracture a hip will die from complications within a year,” Wendel says. Another 25 percent never regain their independence.

A Strong Foundation
Those statistics are why it’s so important to build strong bones at an early age. We reach peak bone mass at about age 25 or 30. “The preteen years are an especially critical age for building strong bones because children need an adequate amount of calcium to support their growth,” Wendel says. After age 30, bone density starts gradually decreasing, accelerating after menopause.

Getting the daily recommended amounts of calcium and vitamin D3, whether through diet, supplements or a combination, is essential to maintaining bone strength and can play a vital role in preventing osteoporosisrelated fractures. For adults 50 and older, the National Osteoporosis Foundation recommends 800 to 1,000 IU of vitamin D3 and 1,200 mg of calcium daily. Weightbearing exercise—walking, hiking, gardening and racquet sports—is also helpful, because exercise that puts stress on bone encourages new growth.

By Deborah Paddison