We
review the results with you immediately after the
procedure.
Takes 1 Hour for
these 9 Scans,
Analysis and Review. Includes detailed report for
you and your Doctor.
Cost is
$300 and we do not bill Insurance. You can use Your
For your
DXA Bone Density!
Dr. Christian has been doing DXA Bone
Density Testing for over 20 years in San Antonio. We evaluate your current bone health with
our Hologic Discovery A Model DXA Bone
Densitometer, one of the most advanced scanners on the market
because of it's ability to do lateral scans and the Instant
Vertebral Analysis! This machine is similar to an x-ray but
emits less radiation than flying on a coast-to-coast flight
and much less than a standard chest x-ray.
It is the gold standard to determine bone density status,
your risk for fractures and for following treatment
programs. Dr. Christian is certified in DXA by
Hologic and is the Radiation Safety Officer.
There are other screening machines
which look at the heel or forearm but unless you have had a
scan which looks at the L1-L4 Lumbar Spine, Bilateral Hips,
Bilateral Forearms and an Instant Vertebral Fracture
Analysis (IVA) you really don't know the status
of your bone health!!
Your results are compared to a young person with
maximum bone density (T-Score) and with someone your age (Z-Score). These scores indicate if you have decreased bone
density and will predict your risk of future problems.
Treatment decisions, in general are based on the
T-Scores, or how you compare to a young person
(approximately age 30) who
has achieved maximum bone density and the recently
developed FRAX Score. The World Health
Organization has defined Osteopenia as T-Scores of
-1.0 to -2.5 and Osteoporosis as T-Scores less than
-2.5.
Our Routine
Protocol for Clients Requesting DXA Bone Density
Testing
This is an AP DXA Scan of
the L1-L4 Vertebra in a 58 year old post
menopausal female. The Total T-score of -0.7
indicates normal bone density but there is
evidence of probable artifact elevation of
the measurements due to the sclerosis and
calcifications seen in the posterior
elements (Spinous Processes and Facet
Joints), so her true Bone Mineral Density is
probably lower. Lateral Views of the spine
might give a better measurement. Her Supine Lateral view of
the spine is below.
This is the Lateral DXA
Scan of the L2-L4 Vertebra only available on
a few DXA Scanners such as our Discovery A. These Lateral views
eliminate any artifact elevation of bone
density due to calcifications in the
posterior elements and give us a true bone
density measurement of these vertebra
without any artifact. This study does
indeed show that this lady has Osteopenic
measurements in the L2-L4 vertebra which was
not apparent in the AP Exam. This
information might influence the treatment
program for this patient. The scanner also
allows for creation of detailed sampling
areas in the middle of these vertebral
bodies to get a more precise measurement of
the bone density in the interior of the
vertebra for following response to
treatment.
This is a DXA Scan of the
Left Hip in a 67 year old male which shows a
T-Score of -1.2 for the Total Hip and a
T-Score of -2.0 in the neck. This is a
definite diagnosis of Osteopenia of the Hip.
The Right Hip results are shown next.
The Right Hip Scan shows a
T-Score of -1.1 for the Total Hip and a
T-Score of -2.2 in the Neck of the Right
Hip. The FRAX score discussed next uses the
lowest Neck Measurement to determine the 10
Year risk of a Hip or other Major
Osteoporotic Fracture.
The Discovery A
also automatically calculates
your
FRAX Score, a tool
developed by the University of Sheffield in 2008
to estimate your 10
year risk of either a Hip or other Major
Osteoporotic Fracture (vertebral, shoulder, forearm)
The risk
is based on the lowest T-Score of the Neck of the
Hip, where most fractures occur, your age, race,
country
and 7 questions about your medical history.
The results shown
are in the 67 year old male above and show the
influence of drinking
more than 3 units
of alcohol a day on the risk of a hip or other major
fracture.
These FRAX Scores show the
10 Year risk of a Hip Fracture or other
Major Osteoporotic Fracture based on the
factors discussed above. It is
apparent that alcohol intake greater than 3
units per day markedly increases the 10 year
risk of a Hip Fracture from 2.3% to 3.4% and
the risk of a Major Osteoporotic Fracture
from 8.5% to 11%. This information might be
helpful in counseling a patient about this
particular risk factor.
These are the forearms scans of
a 24 year old Hispanic female. The negative
T-scores show evidence that this young lady
has lower bone density than females age 30
(T-Score) or females her age (Z-Score).
Women continue to develop their bone density
up until about age 30 so there still is time
to improve these measurements. Her T-Scores
and Z-Scores of the Femoral Necks and L1-L4
spine also showed that she was lagging
behind women age 30 and those her age.
Possibly, the
failure to achieve bone density equal to her
peers was
due to her dietary habits. This is a
bothersome trend that we are seeing more and
more as young women have increasingly bad
eating habits and eating disorders such as
anorexia and bulimia. These scores may
improve with attention to nutrition
and exercise, but if not addressed, this
young lady may enter menopause without ever
achieving her maximum bone density as a
young adult.
The Discovery A Model
allows for both High Definition AP and
Supine Lateral Instant Vertebral Analysis of
the Spine to look for evidence of Vertebral
compression fractures which are sometime
silent but when present indicate a
significant level of loss of bone density.
Patients with these fractures are considered
to have a diagnosis of Osteoporosis and
should be treated to avoid future fractures.
The Hologic Software analyzes each vertebra
separately and can detect compression
changes.
The Lateral Scan can also
be used to detect Abdominal Aortic
Calcification which is an indication of
significant atherosclerosis and predictive
of future heart attacks and stroke.
DXA Body Composition is a
research level tool and can be used to help
set goals for weight loss and gaining of
muscle. You can watch the yellow disappear
and the red increase!! This
lady has a body fat % of 36.9%, too high for
her age.
In 2004 the Surgeon
General of the United States, Richard Carmona, issued
his first report concerning Bone Density Problems. It
is a sobering document which indicates that loss of bone
density is a much more serious problem that we have
previously thought and unless we change our eating and
exercise habits the problem will progress very rapidly.
Already, 10 million Americans
over the age of 50 have developed severe bone thinning or
osteoporosis; an additional 34 million have started down
that road and have an increased risk of fractures. To avoid
bone loss, Carmona’s report recommends getting the
recommended daily amounts of calcium from leafy green
vegetables, milk and cheese, and of Vitamin D; maintaining a
healthy weight and being physically active; and trying to
reduce the risk of falls. Ignoring the problem is expensive.
Americans spent as much as $18 billion on hospital,
physician and nursing home care to treat the 1.5 million
fractures attributed to osteoporosis in 2002. The cost could
double or triple in coming decades.
Many people
think of osteoporosis as a disease of elderly women that
causes them to appear stooped over. These vertebral
fractures that cause the hunching over (called "dowager's
hump"), result in pain, loss of height, reduced lung
capacity and decreased exercise tolerance. But this is only seen when the loss of bone
density is at its late stages.
We develop
our bone density between about age 13 and 30. After age
30, everyone tends to lose bone at a slow but steady rate.
Some people, especially young women and men during adolescence
and young adulthood never
develop their maximum bone density. This can be due to
eating disorders such as anorexia, low calcium intake, too
many sodas/alcohol/smoking/vaping/drug use and sometime due to too much exercise which
results in amenorrhea. Estrogen balance is disrupted when
amenorrhea occurs and bone formation is impaired. This is
called
The Female Athlete Triad, eating disorders, menstrual
disturbances and low bone mass.
This is an example of
the L1-L4 Spine of a 30 Year old Female enrolled in our
Hi-Lo Strength Training Program.
At her young age she has
moderate osteopenia of the L1-L4 Spine and only 83% of the
bone density of a Young woman of 30.
The
Neck of the Right Hip has only
93% of a Young Woman.
The Left Forearm
1/3 measurement
has 97% of the Bone Density of a Young Woman.
These are concerning findings in a woman so young.
But, the good news is now she knows that she never developed
maximum bone density and that she needs to be very faithful
about exercise and nutrition to improve her bone density.
Her history reveals minimal calcium intake and lots of
"Dr. Pepper" and no exercise.
In women, after menopause, the rate
of bone loss increases. While most
fractures due to osteoporosis usually do not develop until
around age 65, osteoporosis has a long, quiet development
period when there are no symptoms at all. It is
important for young and middle aged adults to become aware of
osteoporosis while there is still time to prevent it.
Osteoporosis is not just a disease of women. Men account
for 20% of those with osteoporosis. Most people do not
know they have osteoporosis because there may be no symptoms
until they break a bone. By that time, the disease is
far advanced. Women with histories of dieting or eating
disorders early in life may never achieve maximum bone density
and unwittingly set themselves up for problems possibly in their
50's or early 60's.
After the scan we will spend about 20 Minutes
going over the scan and your risk factors found on our
comprehensive "Risk Factor Questionnaire". We have
discovered many young ladies in their 30's with early signs
of low bone density. In addition, men are not immune to loss
of bone density and many feel that this is a problem that is
extremely under diagnosed in men. In our experience it
is rare to find normal bone density in a man who has a
very stressful lifestyle such as a professional or a
entrepreneur. These men with lots of stress in their lives
have many factors which impair bone health. Stress
lowers Testosterone and Growth Hormone levels which are good
for bones and raises cortisol levels which is bad for bone
health. In addition, these men often do not get enough
good restorative sleep when repair and growth occur. And to
make things worse, they don't exercise, eat poorly and may
smoke or take too much alcohol. And we have yet to see a man
who takes a Calcium or Vitamin D Supplement regularly!!
We submit a detailed report for the referring M.D. and
the patient gets a report also with our recommendations.
Our recommendations always include Hi Lo
Strength Training which was developed in part in the early 1980's by
Ken Hutchins, the founder of SuperSlow Strength Training. He was working with Nautilus at the time
and Nautilus was given the "Nautilus Osteoporosis Project"
and asked to design a strength training program for frail
ladies with osteoporosis. The Original Nautilus
Protocol was a 2 second Positive, 4 second Negative
repetition. The ladies were hurting themselves moving
the weights this fast, so Ken slowed it down to 10 seconds
up and 10 seconds down. The ladies could do this, they
got a lot stronger and bone density improved, however little
data was forthcoming due the the crude measurements of bone
density at that time. To Quote Ken Hutchins "And
if we can assume the body to be logical then bone
strengthening should result from muscular strengthening"
It would make no evolutionary sense to allow the muscle to
get stronger and not allow the tendon and bone attached to
the tendon to get stronger at the same time. Since
aerobics does not build strength, it is a poor choice to
build bone density.
EARLY
DETECTION of Bone Density Loss, TREATMENT with Hi-Lo Strength
Training and
proper nutrition, AND PREVENTION ARE OBVIOUSLY FAR BETTER
ALTERNATIVES THAN THE DISABILITY ASSOCIATED WITH THIS DISEASE.
Some common
osteoporosis risk factors include:
Estrogen deficient postmenopausal women
Caucasian or Asian Race
History of Fracture as an Adult
Maternal history of osteoporosis or other 1st degree
relative
High caffeine intake
Smoking/Vaping and high alcohol consumption
History of eating disorder (Often seen in young women)
