|
|
|
Doing What You Love
My six year old son thinks that being rich has to do with having money. I try to help him understand that being rich involves a whole lot more. If you have your basic needs met, like food, clothes, and shelter, and you have good health, good...
Follicular Unit Extraction vs. Older Methods of Hair Transplantation
Punch grafts, scalp reductions, scalp extensions… In the past, as the names of these earlier procedures indicate, undergoing a hair transplant was a painfully unpleasant process. Men with receding hairlines and balding scalps often resorted to the...
Natural Beauty: The Benefits of Holistic Skin Care
What is holistic skin care? It's a regimen that recognizes that your skin is not just the outermost layer of your body it's also a reflection of your body's internal state. Rather than just treating the surface symptoms, such as wrinkles, sallow...
The Essential Oil Home Medicine Chest – Part I: The Oils
Essential oils provide a wonderful natural-medicine alternative to common ailments we see at home. Their actions are broad and diverse, ranging from topical antiseptics and anti-inflammatories to analgesics, digestive system tonics, and...
The Future Isn't What It Used To Be
This is what they call "Hope"?
We've all gotten used to the idea that certain maladies will be around for a while...like until the Second Coming. Maladies such as cancer, heart disease, diabetes, arthritis...and many more are expected to be...
|
|
| |
|
|
|
|
|
|
The DXA Bone Mineral Density Scan.
The Bone Density test comes in many forms. You may have seen the small machines at Health Fairs or at your local pharmacy.
These devices measure bone density by ultrasound technology. It is inexpensive, portable and there is no radiation exposure. Several studies have shown it to be a good predictor of fracture risk. It is sometimes called Quantitative Ultrasound(QUS).
However, ultrasound is not recommended to monitor osteoporosis long term because of limited precision of the machine and the fact that bone mass at peripheral sites (e.g. heel) changes very slowly. If an ultrasound test reveals an abnormal result we suggest obtaining a confirmatory DXA scan of the hip and spine.
It is also possible to use Quantitative Computed Tomography (QCT) to measure bone density. It is used less often than DXA. It is more expensive, less reproducible and emits a higher radiation dose than DXA.
So let's talk a little about DXA. DXA is short for Dual X-Ray Absorptiometry. It is also known as DEXA, Bone Densitometry or the Bone Mineral Density (BMD) test/scan. It is really the 'gold standard' of bone density measurement techniques. DXA uses a very low radiation dose. The radiation is equivalent to the dose received when flying on an airplane from San Francisco to New York! So as you can see the exposure is minimal, but you should NOT undergo a scan if there is any chance of you being pregnant. DXA measures the BMD in one hip and in the lumbar spine. A few centers will measure both hips. Smaller, more mobile peripheral DXA devices are also used(pDXA). Talk to your physician about which Bone Density Test is available in your area.
So when you have had your scan you will be given a t-score. This is a statistical number that compares your bone density to that of a young adult. The more negative the t-score the worse your bone density. The lower the t-score the higher your risk of fracture. Take a look at this scale to see where your t-score lies.
The World Health Organisation classifies your t-score as follows:
T-SCORE better than -1.0 is NORMAL
T-SCORE from -1.0 to -2.5 is OSTEOPENIA
T-SCORE -2.5 or worse is OSTEOPOROSIS
On the day of the exam, eat normally, but don't take calcium supplements for at least 24 hours beforehand. Wear loose, comfortable clothing, avoiding garments that have zippers, belts, or buttons made of metal. Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan; you may have to
wait 10-14 days before undergoing a DEXA test. Women should always inform their physician or x-ray technologist if there is a possibility they are pregnant.
The results of a DEXA bone density exam are interpreted by a physician specially trained in Bone Densitometry.I am a Certified Clinical Densitometrist with the International Society for Clinical Densitometry (www.iscd.org). I send an interpretation of your results and a signed report to your primary care physician, who will work with you to develop a treatment plan. Usually available within a few days, your test results will be in the form of two scores:
T score — This number shows the amount of bone you have compared to a young adult of the same gender with peak bone mass. A score above -1 is considered normal. A score between -1 and -2.5 is classified as osteopenia, the first stage of bone loss. A score below -2.5 is defined as osteoporosis. It is used to estimate your risk of developing a fracture.
Z score — This number reflects the amount of bone you have compared to other people in your age group and of the same size and gender. If it is unusually high or low, it may indicate a need for further medical tests.
Despite its effectiveness as a method of measuring bone density, DEXA is of limited use in people with a spinal deformity or those who have had previous spinal surgery. The presence of vertebral compression fractures or osteoarthritis may interfere with the accuracy of the test. CT scans may be more useful in such instances. DEXA cannot predict who will experience a fracture, but can provide indications of relative risk.
Central DEXA devices are more sensitive than pDEXA devices, but they are also somewhat more expensive. The peripheral devices don't accurately follow changes in your bones during therapy. A test done on a peripheral location, such as your heel or wrist, may help predict the risk of fracture in your spine or hip. But because bone mass tends to vary from one location to the other, measuring the heel is not as accurate as measuring the spine or hip.
Adrian J Rawlinson MD
http://www.osteoporosis-advisor.com
About the Author
Dr. Rawlinson is the Medical Director of The Osteoporosis Center in San Francisco. He hails from Manchester, England and earned his medical degree from the University of Leeds, England in 1983.
He specializes in the assessment and management of non-surgical musculoskeletal and sports medicine related problems. He has a special interest in Osteoporosis and is a Certified Clinical Densitometrist.
|
|
|
|
|
| National Library of Medicine - National Institutes of Health |
| Part of the National Institutes of Health, the National Library of Medicine offers access to health information for consumer, patient, and physicians ... |
| www.nlm.nih.gov |
|
| Health and Medical Information produced by doctors - MedicineNet.com |
| Doctor-produced health and medical information written for you to make informed decisions about your health concerns. |
| www.medicinenet.com |
|
| Medicine in the Yahoo! Directory |
| Collection of sites for health professionals, with sections on specific disciplines, organizations, continuing education, conferences, publications, ... |
| dir.yahoo.com |
|
| MedlinePlus Health Information from the National Library of Medicine |
| Health information from the National Library of Medicine. Easy access to Medline and Health topics, medical dictionaries, directories and publications. |
| medlineplus.gov |
|
| Medicine - Wikipedia, the free encyclopedia |
| Medicine is a branch of health science and the sector of public life ... The practice of medicine combines both science as the evidence base and art in the ... |
| en.wikipedia.org |
|
| Journal Home - Nature Medicine |
| Nature Medicine has a vacancy for a Locum Assistant Editor for six months. The position involves working in all aspects of the editorial process, ... |
| www.nature.com |
|
| The New England Journal of Medicine: Research & Review Articles on ... |
| The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial ... |
| content.nejm.org |
|
| eMedicine Clinical Knowledge Base |
| eMedicine features up-to-date, searchable, peer-reviewed medical journals, online physician reference textbooks, and a full-text article database in 62 ... |
| www.emedicine.com |
|
| Open Directory - Health: Medicine |
| the entire directory, only in Health/Medicine. Top: Health: Medicine (11429). Description · Medical Specialties (4888); Surgery (2265) ... |
| dmoz.org |
|
| the www virtual library biosciences medicine |
| www.ohsu.edu/cliniweb/wwwvl/ - Similar pages |
|
|
| Medicine - home |
| Bimonthly journal covering the latest results in clinical investigation relevant to hospital and office practice. |
| www.md-journal.com |
|
| Institute of Medicine |
| The Institute of Medicine serves as adviser to the nation to improve health. |
| www.iom.edu |
|
| ScienceDaily: Health & Medicine News |
| Medical Research News. Health news on everything from cancer to nutrition. Full-text, images, updated daily. |
| www.sciencedaily.com |
|
| Google Directory - Health > Medicine |
| Search only in Medicine Search the Web. Medicine. Health > Medicine, Go to Directory Home. Categories. Alternative Medicine (6308) Basic Sciences (66) ... |
| www.google.com |
|
| the world wide web virtual library biosciences medicine |
| www.mcb.harvard.edu/biopages/medicine.html - Similar pages |
|
|
| PLoS Medicine - A Peer-Reviewed Open-Access Journal |
| PLoS Medicine is a peer-reviewed, international, open-access journal published ... Every issue of PLoS Medicine contains a selection of readers' responses. ... |
| medicine.plosjournals.org |
|
| Medicine On-Line - Medicine Online -The International Medical Journal |
| Medicine Online - independent and peer reviewed journal published by Priory Medical Journals - priory.com. |
| www.priory.com |
|
| Entrez PubMed |
| PubMed is a service of the US National Library of Medicine that includes over 16 million citations from MEDLINE and other life science journals for ... |
| www.ncbi.nlm.nih.gov |
|
| Stanford University School of Medicine |
| Home Page of the Stanford University School of Medicine. |
| med.stanford.edu |
|
| Medicine OnLine |
| Meds.com offers medical information and education on cancer (lung cancer, colon cancer, breast cancer, leukemia) and HIV / AIDS for patients, ... |
| www.meds.com |
|
|