Many individuals who suffer bone fractures, and some without fractures, experience decreased bone mineral density or bone strength. Like high blood pressure, the loss of bone strength is not immediately apparent, but can be determined by relatively simple testing. Treatments are now available to prevent further bone loss and in many cases to restore bone strength. This reduces the risk of subsequent fractures.
Bone mineral density or bone strength, is measured with a type of low energy x-ray called a DEXA scan. The scan is entirely noninvasive and takes approximately 15 minutes to complete. The measurement of an individual’s bone mineral density is compared to values of the normal population to determine the extent of bone loss. Patients under active treatment should have follow-up DEXA scans at 1-2 year intervals.
In instances of reduced bone mineral density, it is advisable to establish the cause. This is done by medical history, a brief physical examination, and laboratory studies from blood and urine tests.
Information obtained from the medical evaluation, DEXA scan, and laboratory tests make it possible to estimate the risk of subsequent fractures. We are using an online computerized assessment program called FRAX. FRAX is the World Health Organization’s fracture risk assessment measurement which provides a risk assessment reflecting specific personal features.
Many patients can be treated with supplementary calcium, vitamin D, and weight bearing exercise programs. For other patients, several medications are available that can decrease bone loss, build bone strength, and reduce the risk of subsequent fractures.
Following a fracture, especially one resulting from minimal trauma, or other indications of decreased bone strength, your orthopaedic surgeon may refer you for a metabolic bone assessment. You and your orthopaedic surgeon will be informed of the results of testing, the extent of the decreased bone mineral density, if any, and treatment recommendations.
We will communicate with your primary care physician and you may choose that s/he manage the treatment program.