How strong are your bones?

From Northern Nevada Medical Center

About 28 million Americans -- primarily women -- have a severe and potentially disabling disease but may not know it until they break a bone.* A new screening for bone density, which is closely related to bone strength, is available to diagnose and treat osteoporosis before it becomes a crippling fact.

Bone density testing in offered for osteoporosis, the disease that silently and over the years thins and weakens bones. By the time a woman reaches her sixties and seventies,her bones may become so weak that they fracture easily. A broken hip or fracture of the spine can transform an active woman into a homebound, dependent invalid.

* Osteoporosis is associated with 1.3 million fractures each year, including:

• 250,000 hip fractures
• 500,000 spinal fractures
• 240,000 wrist fractures

Osteoporosis isn't just a disease of the elderly; all postmenopausal women are at risk. It's estimated that at age 50, a woman has a 40% chance of experiencing an osteoporotic fracture sometime during her remaining lifetime.

Osteoporosis generally has been diagnosed only after a fracture occurs, in comparison to blood pressure or cholesterol, indicators which can be used to prevent disease. Now, bone density screening allows the same type of prevention. The screening is done with the Dual Energy X-Ray Absorption, or DEXA, which uses low-dose radiation (lead-lining isn't necessary) to scan hips, spine and forearm, common fracture areas. The patient lies fully clothed on a table for the scans, which take a total of about fifteen minutes. Clinical results have shown the screenings to be highly accurate and consistent. "Evaluating bone density using conventional X-ray techniques won't reveal a problem until a person has lost at least 30 percent of bone mass -- and that's just too late," said Dennis J. Brown, M.D. "Now, in a matter of minutes, we can get an accurate picture of a person's bone density early enough in the disease to better enable us to make a real difference in the outcome," he added. Diagnosis is vital since the correlation between low bone mass and fracture is even stronger than the correlation between cholesterol and heart disease.

Lifetime risk of death due to hip fracture is equal to that of breast cancer for 50-year-old white postmenopausal women. Half of hip fracture victims will be disabled, many of then permanently, and up to 20 percent of patients with hip fractures will die within one year. Patty Crowell, RT, is on a diagnostic imaging staff and has been specially trained on the new equipment. "It's been fascinating for me to learn bone densitometry," she said. "The treatment advances are amazing; women don't have to end up bent-over and brittle," she added.

Education is believed to be essential by osteoporosis prevention advocates precisely because the disease is preventable as well as treatable when detected early enough. "It's important to educate patients and let them talk to their physicians; it's a 'percolate-up' effect," said Crowell. Once osteoporosis is diagnosed, treatment options range from exercise and modification of diet to medications when appropriate, which can include hormonal as well as non-hormonal drugs. "People are thrilled to be able to adopt a proactive method of staying healthy to prevent a disease that really debilitates their lifestyles," Crowell said.

*National Osteoporosis Foundation, 1997.