How Strong are Your Bones - The Osteoporosis BMD Test Reveals

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Osteoporosis is a disease in which bone substance is depleted faster than it can be replaced, leading to weakened and brittle bones. Weak bones increase risks of fracture from falls. Brittle bones break more easily, even from very slight trauma. The bones that are more prone to fractures are usually around the wrist, spine and hip.

In Singapore, among women 60 years and older, there are 2,000 hip fracture cases every year, due to osteoporosis. Hip fracture patients suffer much pain, and about 20 per cent of such patients die within the first year of their injury.

There are good ways of diagnosing osteoporosis before such fractures occur and many treatments are available to reduce the chances of such fractures.

The plan to combat osteoporosis for those at low risk and high risk is different. Both groups can benefit from a healthy calcium intake of SOOmg a day and regular weight bearing exercise. For the elderly, it is also important to prevent falls. However, lifestyle measures alone are not adequate for those in the high risk group, they need to take a BMD test and follow up with prescribed treatments.

What is BMD?

The BMD test measures how porous the bones are. BMD is expressed in grammes per square centimetre. The lower the BMD, the higher the risk of getting osteoporosis and fractures.

BMD is measured with a densitometer. which uses low doses of X-ray radiation. There are different types of densitometers. The single X-ray absorptiometry densitometer (SXA) measures BMD in the forearm only, while the dual energy X-ray absorptiometry densitometer (DXA) measures BMD in the forearm, spine and hip as well. Between the two, DXA is preferred.

What Does The BMD Test Involve?

The test is simple and painless. There are no injection, no special medication and patients do not need to fast.

Patients are asked to lie down on their backs on a special bed. Once they are comfortably positioned, they have to keep still while a movable arm scans the length of the body and passes over the area to be tested. The scan produces an image showing the BMD in various parts of the skeleton. This procedure takes about 20 minutes.

Who Needs To Take a BMD Test?

High risk patients should take the test. Patients at high risk are females, those who are 65 years and above, those who have had previous osteoporotic fractures or with family history of such fractures. Those taking corticosteroid medications (which are synthetic versions of natural hormones) also belong to the high risk group.

To find out if you need to take a BMD test, use this easy formula: subtract your weight in kg from your age, eg 71 years - 49kg = 22. If the value is more than 20, you should take the BMD test.

If the value is a negative number, eg 50 years - 52kg = -2, you do not have to take the test. For values between zero to 20, you should consult your doctor, who will ascertain if you need to take a BMD test on a case--by-case basis.

How Often Should a BMD Test Be Done?

A BMD test should be done every one to two years to determine a patient's improvement after starting medication. For those who have low bone mass but do not need medication yet, repeating the test will reveal if they are losing bone mass too quickly. If so, they will need to start medication.

What Implications Does The BMD Test Have an Osteoporosis Treatment?

To prevent the escalation of osteoporosis, early detection of bone loss is crucial. The BMD test is effective in assessing the risk of fractures. Patients with fractures will need treatment, regardless of their BMD, to prevent further fractures from happening. Those with very low BMD need treatment before fractures occur.

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