Twin power x-ray absorptiometry (DXA) is the gold customary for assessing bone mass and evaluating fracture threat. However new applied sciences make clear information gaps not crammed by DXA alone and generally counsel the necessity for extra procedures to precisely assess bone well being. A presentation on the 2023 Annual Assembly of The Menopause Society in Philadelphia September 27-30 will deal with the evolution of know-how to raised diagnose bone fragility.
The dialogue of bone well being is particularly related for postmenopausal ladies who’re extra susceptible to osteoporosis and osteopenia due to declining estrogen ranges that happen throughout the menopause transition. Measurement of bone mineral density by DXA is the predominant means for figuring out if a girl is predisposed to fragility fractures. That is as a result of the vast majority of the bone’s energy, 60-75%, is accounted for by bone mass.
However bone mass alone does not inform all the story as to the energy of a girl’s bones and her threat for fractures. On the 2023 Annual Assembly of The Menopause Society, Dr. Marcella Walker from Columbia College’s Division of Endocrinology will lead a dialogue centered on newer non- or minimally invasive applied sciences which can be yielding extra info past bone mineral density to offer a fuller image of a affected person’s total bone well being.
Evaluation advances embody the trabecular bone rating (TBS), which is an oblique measure of spine trabecular microarchitecture obtained from the DXA picture to foretell fracture threat independently of, however at the side of, BMD. Vertebral fracture evaluation (VFA), additionally carried out on a densitometer, can detect vertebral fractures, a lot of which go undetected. In simply the previous two years, the FDA additionally permitted impression microindentation (IMI), which measures the gap a probe extends into the tibial bone cortex, thereby successfully measuring bone materials energy. It correlates with the bone’s potential to withstand the event of cracks and is carried out utilizing a minimally invasive, hand-held system.
In response to Dr. Walker, there’s a lot thrilling know-how turning into obtainable that may inform us so much a couple of bone’s energy. Whereas she believes there’s super worth in using a number of measurements of bone high quality in some sufferers, she cautions that many ladies are usually not receiving the minimal screening for osteoporosis with bone mineral density measurement by DXA.
It is vital for each clinicians and sufferers to grasp that osteoporosis does not trigger any signs till a fracture happens. That’s the reason it’s so important for ladies in danger to have bone mineral density measured by DXA. Adjunctive applied sciences, akin to TBS and VFA, are significantly useful to additional threat stratify ladies near the therapeutic intervention threshold the place this info would possibly change a choice to start out therapy.”
Dr. Marcella Walker, Columbia College’s Division of Endocrinology
“This presentation ought to present helpful insights concerning the varied applied sciences obtainable to healthcare professionals with the intention to get a extra correct image of their sufferers’ threat for fracture” says Dr. Stephanie Faubion, medical director for The Menopause Society. “Bone well being and avoiding fractures is such an vital problem for ladies at midlife.”
Drs. Walker and Faubion can be found for interviews earlier than and after the presentation on the Annual Assembly.