Osteoporosis is a common condition that can lead to painful and disabling fractures. Those at risk need appropriate assessment of their bone fragility.
Every year in the UK:
- 300,000 osteoporotic fractures
- Over £2.3 billion per year on hospital and social care costs for hip fracture alone - (approx. £6 million/day)
One ‘fragility fracture’ increases the risk of a second
After a first fracture:
- 23% of all further fractures occur within 1 year
- 54% of all further fractures occur within 5 years*
Ashford and St Peter’s Hospitals NHS Trust have 2 DEXA scanners, one situated at each site.
What is a DEXA scan?
A DEXA scan is a quick, sensitive and accurate test that will specifically measure the density of the bones.
It is endorsed by the National Osteoporosis Society as the Gold standard for diagnosing
The waiting time for a DEXA scan at either site is two weeks.
Who should be scanned?
Bone density assessments should ideally take place in those at risk of osteoporosis to identify early bone loss, to take action to improve this and prevent fractures which cost the CCG a huge amount of money every year.
If you suspect your patient has a vertebral collapse or Osteoporotic fracture a plain
X‐ray is the first diagnostic test of choice.
DEXA is recommended for patients who have the following risk factors:
Criteria for Performing a DEXA Scan
- Family history of osteoporosis (especially parental hip fracture).
- Patients with a disease known to cause osteoporosis: Endocrine: hypogonadism, 1o hyperparathyroidism and thyrotoxicosis, diabetes, chromosomal disorders (e.g. Turner’s syndrome) or CKD.
- Haematological: myelomatosis, systemic mastocytosis.
- Rheumatological: rheumatoid arthritis, ankylosing spondylitis.
- Gastrointestinal: malabsorption syndrome, chronic liver disease.
- Patients with back pain who have had a plain X‐ray first and do not have significant Osteoarthritis.
- If a vertebral fracture is seen on a plain X‐ray.
- Women with early menopause (less than 45 years) or a history of missed periods >6/12 before menopause.
- Patients needing a base line scan prior to commencing treatment with, e.g. HRT / Zoladex , Arimidex or Oestrogen.
- Osteopenia reported on spine X‐ray by a radiologist.
- Equivocal / abnormal results on a heel ultrasound or forearm DEXA scan.
- Long term anti‐ epileptic therapy.
- Previous low trauma fracture (vertebrae / hip / forearm) and under 75 years of age.
- Loss of height / kyphosis.
- Low BMI (e.g. eating disorder).
- HIV Infection with or without treatment.
- Other medication that may increase the patient’s risk of Osteoporosis (e.g. Steroids, Warfarin and Clexane).
- Smoker or high alcohol consumption (greater than 3 units of alcohol per day).
- Low vitamin D levels.
Repeat scans (usually 2-3 years apart)are appropriate if there is Osteoporosis/Osteopenia, to confirm treatment efficacy or as appropriate when the patient is on a drug holiday.
After scanning a comprehensive report is generated and will be returned to you within 7-10 days, in order for you to make a speedy and accurate diagnosis of Osteoporosis, benefiting both the patient and the CCG.
Statistics and graph came from the NOS website http://www.nos.org.uk/health-professionals
A copy of this document is available to download here.