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DEXA SCANNING IN OSTEOPOROSIS PATIENTS: WHEN TO FOLLOW UP?



Abstract

The primary purpose of this study was to evaluate the appropriate use of Dual Energy X-ray absorptiometry (DEXA) scanning in the follow-up of osteoporosis. The secondary aim was to ascertain the correlation between body mass index (BMI) and osteoporosis in the study population.

Six hundred and sixty six patients were sent for DEXA scanning from the Osteoporosis clinic at 1-Military Hospital from June 1998 to February 2004. A descriptive expost facto study of primary data was undertaken, consisting of patient records, test results and post treatment test results. Patients were classified according to their World Health Organization (WHO) classification of bone density. Each of the categories was then followed-up to determine an improvement or deterioration in a specific category.

A total number of 307 (46.1%) follow-up DEXA scans were done over a period of five years. The majority of patients’ bone mineral density (BMD) remained in the same WHO category while a significant number improved to a higher category. The biggest improvement was in elevating patients from an osteoporosis category to an osteopenic category. Only a small number of patients’ BMD deteriorated.

A significant positive correlation between BMI and T-scores for all the patients who received DEXA scans was found. It is therefore apparent that it is safe to follow-up patients with osteoporosis by means of DEXA scanning only once every four to five years. The correlation between BMI and bone mineral density, might serve as a useful guide to identify patients qualifying for more frequent follow up scans.

Correspondence should be addressed to: Léana Fourie, CEO SAOA, PO Box 12918, Brandhof 9324 South Africa.