The Testing Tools


Who should be tested? The American Congress of Obstetricians and Gynecologists recommends bone mineral testing be offered to all postmenopausal women age 65 and older, as well as younger women who have one or more risk factors for osteoporosis. Moore, 55, falls into that second camp: She went through menopause at age 42 (estrogen keeps bones strong, so early menopause means lost protection), weighs just 127 pounds (the cutoff weight that indicates smaller bones, which are more fragile), and has broken a wrist and bone in her foot from falls in recent years (strong bones rarely break from regular, standing falls). There’s no consensus on how often the scan should be repeated, but a recent study found that if your bones test healthy, you might not need another scan for more than a decade. (Women with—or close to—an osteoporosis diagnosis should test more frequently.) Fortunately for Moore, her gynecologist, Xiao-Mei Zeng, MD, in Boca Raton, FL, makes it a practice to query all her patients about their osteoporosis risks and to order testing for appropriate patients. “No one wants to break a bone. When I tell women the test will show what’s happening they are eager to do it,” Zeng says. DXA is a low-dose X-ray that measures the density of two


distinct bones, typically the hip and lumbar spine. During her appointment, Moore laid on her back on the bed of the machine (similar to a tanning bed without the cover). The technician remotely slid the digital X-ray device—which was attached to a moving panel above Moore’s body—down the length of her lower torso capturing images of Moore’s lower lumbar and pelvic bones. Unlike with a mammogram, Moore remained fully dressed, and the machine didn’t touch or compress any part of her body. A computer monitor gathered the results, which were then sent to Dr. Zeng. Moore’s exam also included the calculation of her “FRAX


score,” an algorithm that determines a person’s 10-year probability of a major bone fracture. She was asked 11 questions that are known to affect risk, including height and weight and whether she smokes, drinks more than one glass of alcohol a day, has rheumatoid arthritis, or has ever broken a bone. (You can calculate your own FRAX score at www.shef.ac.uk/FRAX/tool.jsp. Choose your ethnicity under the “calculation tool” menu before beginning, because some ethnic groups, like Caucasians, face higher risks.) Combining Moore’s answers with the results of her DXA test make predictions of future fracture risk even more accurate.


8 pause SPRING / SUMMER 2012


Henrik Sorensen/Stone/Getty Images


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