What is BMD Assessment and its Significance in Treating Osteoporosis
Dr. Manoj Haridas
KIMSHEALTH Trivandrum
Orthopedics
What is BMD Assessment and its Significance in Treating Osteoporosis
Osteoporosis is that creepy monster lurking in the dark, waiting to manifest itself as you age and get less active. This age-related disease is a progressive skeletal condition that is characterized by reduced bone mass and deterioration in the micro-architecture of the bone tissue. As a result, bones become increasingly fragile and prone to fracture. When young, bone formation exceeds bone resorption, but by the third decade of life, this process starts on a reverse trend. By the age of 50, most women would have lost about 2% of their bone mass and by age 80, about 25% of their bone mass. The decline is worse in women and progresses at a higher speed during the menopause period.
This painful condition can have devastating physical, psychosocial and economic effects on the victim. As one osteoporosis patient put it very eloquently…. “People with osteoporosis do not just die; they slowly break apart”. This disease is usually overlooked (largely because it’s clinically silent), till one fine day when it manifests itself as a fracture, which normally shouldn’t have happened. Osteoporotic fractures are associated with low bone mineral density (BMD) and include fractures of areas like the hip, spine, shoulder and forearm.
A bone mineral density test can be conducted to measure the skeletal bone mass. The amount of bone lost will tell your doctor about the denseness and strength of your bones, as well as your propensity for fractures. A bone density with a T score lower than -2.5 is considered as showing osteoporosis while T values between -1 and -2.5 can be classified as osteopenia (don’t celebrate yet, as this means you are also on the way to osteoporosis!)
Checking the density of the bone involves a safe non-invasive procedure that uses very low doses of radiation and lasts for just a few minutes. The DEXA scan is the most accurate way used to measure the bone mineral density (BMD) and stands for ‘dual-energy x-ray absorption’. It uses two different x-ray beams to estimate bone density in the hip and spine areas. Denser bones allow less x-ray beams to pass through the bone as compared to thinner bones and soft tissues.
So the thicker your bones are, the longer it takes to develop osteoporosis. If the scan proves that your BMD is lower than normal, you can always work on improving it by changing to a calcium, vitamin D and mineral-rich diet, as well as indulging in weight-lifting exercises. A low BMD is indicative of osteoporosis, with doctors using the lowest T-score to make a diagnosis; for example if the spine T-score is -3 and hip T-score is -2.5, then the spine T-score would be used to make a diagnosis. The more negative the T-score is, the higher are the chances of your attaining fractures from minor falls. Negative values mean you have thinner bones than a 30-year-old while positive values indicate that your bones are thicker than a 30-year-old’s bones.
According to WHO, osteopenia is characterized by T-scores of -1 to -2.5; osteoporosis is characterized by values of < -2.5 and severe osteoporosis by T-scores of <-2.5 plus presence of fractures.
Aside from its use to check for bone density, DEXA scan can also be used to detect if cancer has metastasized, or spread to the bones.
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