Osteoporosis Back Pain

A Typical readout from DEXA study.

Osteoporosis is a condition with a loss of bone tissue producing a low bone mass leading to increased risks of fracture. DEXA (Dual Energy Xray Absorptiometry) scanning is the gold standard method for assessing bone mass and projecting future fracture risks. This low dose X-ray technique is painless and not claustrophobic and is available in the new imaging department at the Tunbridge Wells Hospital.
If patients wear trousers without zip fasteners then they have no need to undress for this examination which typically takes about 20 minutes.

Patients are also given a questionnaire to define their risk factors for osteoporosis and generate a FRAX score with the report. This WHO endorsed assessment increases the clinical usefulness of DEXA scanning by refining the fracture risk in the light of additional clinical risk factors. These include fracture history, parental hip fracture history, steroid administration, presence of rheumatoid arthritis, current smoking and alcohol history as well as causes of secondary osteoporosis.

The combination of DEXA and FRAX gives the most up to date, accurate assessment of future fracture risks to determine which patients will benefit from interventional drug therapy. The DEXA scan generates a “T score” which gives a comparison of patients bone density with young normals and a “Z score” giving a peer comparison.

 DEXA measurements are stratified in 3 categories following hip and spine density measurements according to the T score and the WHO post menopausal female categorisation of bone density. Normal patients have a T score of better than -1, osteopenic patients between -1 and -2.5 and osteoporotic patients less than -2.5.

Thus patients are stratified as normal (53%) , osteopenic (40%) and osteoporotic (7%). This allows a GP or Rheumatologist to determine exactly what the best course of treatment is for their patient.