Osteoporosis, a disease that weakens bones and increases the risk of fractures, affects millions of Americans. The National Osteoporosis Foundation estimates that about 54 million people in the United States have osteoporosis or low bone mass. Research suggests that one in two women and one in four men over age 50 will break a bone due to osteoporosis during their remaining lifetime.
Fractures from osteoporosis can significantly impact quality of life, leading to reduced mobility and increased risk for other health issues. “We know that fractures, especially hip fractures, tend to send people into other co-morbidities,” said RaDonna Pirkle, Physician’s Assistant and Certified Clinical Densitometrist at St. Joseph’s/Candler. “They tend to develop a sedentary lifestyle, gain weight and get depressed.”
A woman’s lifetime risk of hip fracture is equal to the combined risk of developing breast, uterine, and ovarian cancer. Up to 20 percent of women who suffer hip fractures die within one year of the fracture.
Early detection is key in preventing the effects of osteoporosis. Bone density measurement is considered an effective method for early diagnosis. At St. Joseph’s/Candler imaging centers, dual-energy X-ray absorptiometry (DEXA) scans are used for this purpose.
“Osteoporosis is more common than lung cancer and breast cancer put together, but it’s not one of the big C’s so it gets put to the side,” Pirkle said. “Chances are if you end up with osteopenia or osteoporosis you are going to get hurt and became fragile, and once you are fragile, it’s hard to come back from that.”
Medicaid recommends bone mineral density testing every two years for post-menopausal women; men over age 50-55 should also consider testing.
Several factors contribute to osteoporosis: family history; smoking; heavy alcohol use; lack of exercise; diets low in calcium, phosphorus or Vitamin D; certain medical conditions such as hypothyroidism or rheumatoid arthritis; some medications; and soft drink intake.
The DEXA scan measures bone mineral deposit (BMD) at specific sites—typically the non-dominant hip and lower lumbar spine—and compares results with averages based on age, race and sex as well as peak BMD values found in healthy young adults.
Most DEXA scans are performed on post-menopausal women but may also be done for younger individuals when indicated by certain drugs or autoimmune disorders such as Crohn’s disease. Chemotherapy and radiation treatments can also lead to decreased bone density regardless of age.
Insurance coverage for these tests may depend on individual medical history.
A DEXA scan typically takes between a few minutes up to 20 minutes. Patients should arrive early to complete a questionnaire regarding their medical background which may influence how often testing is recommended.
Patients undergoing a DEXA scan should wear comfortable clothing without metal fasteners or body jewelry near measured areas.
Radiation exposure from a DEXA scan is minimal—less than what most people receive from ten minutes in sunlight or less than a standard chest X-ray. “Being in the sun for 10 minutes exposes you to more radiation than the exposure from a DEXA Scan,” Pirkle noted. “It’s the lowest energy they make.” Pregnant patients should notify their physician before undergoing any procedure involving radiation.
Test results include T-scores (comparing BMD with healthy young adults) and Z-scores (comparing BMD with peers). A T-score above -1 indicates normal bone mass while -2.5 or below signals osteoporosis.
Bone density screenings are available at several St. Joseph’s/Candler locations including Telfair Pavilion at Candler Hospital, SJ/C Imaging Center – Pooler, SJ/C Imaging Center – Bluffton, and Telfair Breast Imaging Center – Eisenhower. Physician referral is required for testing appointments at these centers:
– 912-819-7000 (Telfair Pavilion)
– 912-748-0068 (Pooler)
– 843-836-4300 (Bluffton)
– 912-691-1460 (Eisenhower)
Treatment options after diagnosis can include vitamin supplements and increased exercise levels under physician guidance.
“I have seen a lot of cases where patients have increased their bone density just by taking over-the-counter calcium, Vitamin D and a multivitamin,” Pirkle said. “Just be sure to talk to your doctor.”
