Dual power x-ray absorptiometry (DXA) is the gold customary for assessing bone mass and evaluating fracture threat. But new applied sciences make clear data gaps not crammed by DXA alone and typically counsel the necessity for added procedures to precisely assess bone well being. A presentation on the 2023 Annual Meeting of The Menopause Society in Philadelphia September 27-30 will deal with the evolution of expertise to higher diagnose bone fragility.

The dialogue of bone well being is very related for postmenopausal girls who’re extra weak to osteoporosis and osteopenia due to declining estrogen ranges that happen through 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’s as a result of nearly all of the bone’s energy, 60-75%, is accounted for by bone mass.

But bone mass alone does not inform your entire story as to the energy of a girl’s bones and her threat for fractures. At the 2023 Annual Meeting of The Menopause Society, Dr. Marcella Walker from Columbia University’s Division of Endocrinology will lead a dialogue centered on newer non- or minimally invasive applied sciences which might be yielding extra data past bone mineral density to supply a fuller image of a affected person’s general bone well being.

Assessment advances embody the trabecular bone rating (TBS), which is an oblique measure of backbone trabecular microarchitecture obtained from the DXA picture to foretell fracture threat independently of, however along with, 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 accredited impression microindentation (IMI), which measures the space a probe extends into the tibial bone cortex, thereby successfully measuring bone materials energy. It correlates with the bone’s capability to withstand the event of cracks and is carried out utilizing a minimally invasive, hand-held machine.

According to Dr. Walker, there may be a lot thrilling expertise turning into obtainable that may inform us rather a lot a couple of bone’s energy. While she believes there may be great worth in using a number of measurements of bone high quality in some sufferers, she cautions that many ladies aren’t receiving the minimal screening for osteoporosis with bone mineral density measurement by DXA.

It is essential for each clinicians and sufferers to know that osteoporosis does not trigger any signs till a fracture happens. That is why it’s so important for ladies in danger to have bone mineral density measured by DXA. Adjunctive applied sciences, reminiscent of TBS and VFA, are notably useful to additional threat stratify girls near the therapeutic intervention threshold the place this data may change a call to start out remedy.”

Dr. Marcella Walker, Columbia University’s Division of Endocrinology

“This presentation should provide valuable insights about the various technologies available to healthcare professionals in order to get a more accurate picture of their patients’ risk for fracture” says Dr. Stephanie Faubion, medical director for The Menopause Society. “Bone health and avoiding fractures is such an important issue for women at midlife.”

Drs. Walker and Faubion can be found for interviews earlier than and after the presentation on the Annual Meeting.