Monitoring Osteoporosis

A final, important component of any osteoporosis treatment plan is regular monitoring and follow-up to ensure that the treatment plan is working effectively and make adjustments as necessary. Both follow-up bone density testing and physician checkups are recommended.

Periodic Bone Density Testing

Some doctors recommend periodic bone density testing, usually DEXA bone scans, such as every 1 to 2 years for people diagnosed with osteoporosis or at risk for developing osteoporosis. Periodic DEXA scans for these patient populations allow both:

  • Overall assessment of the change in the patient’s bone density and whether he or she is considered to have low bone mass or full blown osteoporosis, and;
  • Monitoring of the effectiveness of osteoporosis treatments, which informs the physician if the patient’s osteoporosis medications and lifestyle changes are effective in slowing bone loss and/or rebuilding bone mass.
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The use of DEXA bone scans to monitor treatment is considered by some to be controversial, because the change in bone density over time is slow and can be less than the error rate of the machine itself.

The use of periodic bone density testing in an individual patient’s treatment will depend on the preference of the treating physician, the coverage by the patient’s insurance company or by Medicare, and by the patient’s overall risk for osteoporosis.

Regular Osteoporosis Follow-Up With a Physician

The good news about osteoporosis is that to a large extent it is preventable and treatable. However, an individual’s personal plan to prevent and treat osteoporosis may include multiple components and challenging lifestyle changes. In order for osteoporosis prevention and treatment to be successful, the patient will need to practice diligent follow-through and seek regular care by the treating physician or healthcare team. This may be accomplished by incorporating a discussion, exam and diagnostic tests focused on bone mass into the patient’s regular annual exam, or by scheduling a periodic appointment focused solely on bone mass/osteoporosis.

The key is making sure that follow-up takes place so that the elements of the osteoporosis prevention and treatment plan can be adjusted as needed to slow/stop bone loss to the maximum extent possible.

The single most important thing to remember is that even after osteoporosis has been diagnosed it is possible to slow bone loss and build bone density. Those at increased risk for osteoporosis do not have to accept the disease and the risk of osteoporosis-related fractures as their inevitable fate.

Osteoporosis and the fractures it causes are largely preventable and treatable and scores of patients have successfully held it at bay.

References:

  1. National Osteoporosis Foundation – Prevention, Prevalence. www.nof.org. Accessed 5/19/06.
  2. National Osteoporosis Foundation – Prevention, Prevalence. www.nof.org. Accessed 5/19/06.
  3. National Osteoporosis Foundation – Prevention, Prevalence. www.nof.org. Accessed 5/19/06.
  4. The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center. “Secondary Osteoporosis”, Volume 4, Number 1, December 2001. http://www.niams.nih.gov/Health_Info/Bone/...Accessed 7/11/06.
  5. National Osteoporosis Foundation – Prevention, Prevalence. www.nof.org. Accessed 5/19/06.
    & American College of Radiology – Bone Densitometry: http://www.radiologyinfo.org/en/info.cfm?pg=dexa. Accessed 8/23/06.
  6. National Osteoporosis Foundation – Patient Info - Medications. www.nof.org. Accessed 5/19/06.
  7. Boning up on osteoporosis. FDA Consumer Magazine. www.fda.gov. http://www.fda.gov/ForConsumers/. Accessed 7/11/06.
  8. National Osteoporosis Foundation – Patient Info - Medications. www.nof.org. Accessed 5/19/06.
    & National Institutes of Health (MedlinePlus http://www.nlm.nih.gov/medlineplus. Accessed 8/23/06.)
  9. National Osteoporosis Foundation – Patient Info - Medications. www.nof.org. Accessed 5/19/06. & AAFP (http://familydoctor.org. Accessed 8/23/06.)
  10. National Osteoporosis Foundation – Patient Info - Medications. www.nof.org. Accessed 5/19/06.; National Institutes of Health (MedlinePlus http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603018.html#brand-names. Accessed 8/23/06.)
  11. National Institutes of Health, Office of Dietary Supplements. Dietary Supplement Fact Sheet: Calcium. http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Accessed 7/11/06.
  12. Optimal Calcium Intake. NIH Consens Statement Online 1994 June 6-8; 12(4):1-31. Accessed 6/14/06.
  13. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press, Washington, DC, 1999. Referenced in National Institutes of Health, Office of Dietary Supplements. Dietary Supplement Fact Sheet: Vitamin D. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h10. Accessed 7/11/06.
  14. American Academy of Orthopedic Surgeons – Smoking and Musculoskeletal Health. AAOS website - http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=240&topcategory=Wellness. Accessed 6/4/06.
  15. National Institute of Alcohol Abuse and Alcoholism (part of NIH) - Alcohol and Other Factors Affecting Osteoporosis Risk in Women. http://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm. Accessed 6/4/06.
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