Statistics: 8 million Americans have osteoporosis and another 18 million have osteopenia (low bone mass but not yet osteoporosis). 80% of osteoporosis cases occur in women and 50% of all woman over the age of 60 have osteoporosis as do 50% of all men over the age of 70. Each year in the United States, osteoporosis is responsible for more than 1.5 million fractures including 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites, at a cost exceeding $13 billion. More new cases of osteoporosis are diagnosed each year than all gynaecological malignancies combined. The lifetime probability that a 50-year-old will have a hip fracture 14 percent (one in seven) for a white woman and 5 to 6 percent (one in 19) for a white man. In addition to fragility fractures, osteoporosis is also a frequent undiagnosed source of back and skeletal pain. At present, less than 8% of those afflicted with osteoporosis are being treated, presumably because the other 92% have never had a test for this disease.
Throughout your lifetime, some older bone is removed (resorption) and some new bone is added to your skeleton (formation). During the growth years, childhood and the teenage years, bone formation exceeds bone resorption. As a result, your bones become longer, larger, heavier and denser. Bones stop growing longer after the teenage years but bone formation exceeds resorption, hence bones continue to grow harder and denser, right up until about age 30. After 30, the pace of bone formation slows and bone resorption begins to exceed bone formation. Past 40, the average annual rate of bone mineral loss is about 0.5% per year. This age-related bone loss begins earlier and proceeds more rapidly in women and tends to accelerate just after menopause. Untreated, cumulative bone lost over a lifespan ranges from 20 to 30 percent in men and 40 to 50 percent in women.
Osteoporosis, or porous bone, develops when bone loss reaches the point that the structural integrity of the bone is compromised, leading to an increased susceptibility to fractures of the hip, spine, and wrist. Although most commonly age related, osteoporosis also develops whenever bone resorption occurs too quickly or bone formation occurs too slowly.
Critical Information about your Bones
The 3D QCT Bone Density Study provides you the critical information you need to identify your risk of osteoporosis. With early detection, the process of bone mineral loss can be arrested and reversed. An essential exam for all post-menopausal women, this test is considered medically necessary for all individuals at increased risk for bone mineral loss because of medications, chronic illness or age greater than 65 years and is reimbursed by most insurance with a physician's order. This test is also included with the whole body scan at no additional charge.
How we Measure Bone Health
Currently there is no practical measure of bone strength. Bone mineral density (BMD) is used as a proxy measure of bone strength. Mineral density accounts for about 70 percent of bone strength. The World Health Organization (WHO) defines osteoporosis in women as a BMD that is 2.5 standard deviations below the mean of a young white adult female. There is ongoing discussion as how to apply this criterion to men, children and across ethnic groups. Because of difficulties in obtaining accurate measurements of mineral density and of standardization between instruments and bone sites, controversy exists among experts regarding the continued use of this diagnostic criterion.
While there are many techniques available to measure bone density, SXA, DEXA, ultrasound; the high precision 3D Quantitative CT (QCT) bone density test is the only method that provides a true volumetric measurement of bone density that is capable of distinguishing between the exterior cortical bone and the interior trabecular bone. There are two bone compartments; trabecular bone is located deep in the bone while compact cortical bone makes up the hard exterior of the bone. Because the trabecular bone is the more metabolically active compartment, it is where bone loss begins and its loss is the most sensitive indicator of future fracture risk. It is the canary in the coal mine. The mineral density of the trabecular bone in the spine is the most reliable indicator of overall bone health. By focusing only on the trabecular bone compartment, the 3D QCT exam takes the best picture of your bones.
Factors sharply increasing your risk of developing osteoporosis.
Body Shape: thin or small frame people are higher risk.
Genetics: osteoporosis in the family or ethnicity: Asians & Caucasians are at higher risk. Inadequate intake of Calcium or Vitamin D
Medications: thyroid hormone excess, glucocorticoids, hypoestrogenemia, heparin, & anticonvulsant therapy to name a few.
Lifestyle: physical inactivity
Chronic illnesses: such as: hyperthyroidism, end stage kidney disease, cystic fibrosis, hyperparathyroidism, celiac disease, inflammatory bowel disease, anorexia, and other metabolic bone diseases.
Other habits: cigarette smoking or excessive alcohol consumption
Vertebral Compression Fracture