Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Measuring Bone Loss

Thursday, 15 October 2009 01:19 PM

Question: My doctor uses a device that measures the middle finger to determine bone loss. How accurate is this method? She wanted me to take Boniva. However, research tells me this drug can have wicked side effects that may not disappear for years. In addition, the bones it claims to build are not new bones but are because of the medication suppressing the growth of new bones and hardening the old ones. This gives the illusion of more bone mass but it actually consists of old, brittle bone material that shatters and breaks more easily than if you didn't take the medication at all.

Dr. Hibberd's Answer:

Osteoporosis involves a failure to mineralize bone fully. Thinned bone tends to break easily and compress more easily, which results in pain and sometimes in significant disability. Osteoporosis is very common in post-menopausal women, and even in some men. It is reliably diagnosed with a DEXA scan that involves measurements of your lower lumbar spine and your femur/hip areas, which is expressed as a Z score and a T score.

Numerous screening devices are marketed, usually measuring heel densities, but none is approved for more than screening and certainly not for diagnosis. Numerous variables that can affect their readings do not necessarily indicate osteoporosis. I certainly would not base a diagnosis upon a finger densitometry reading. Ask your doctor to order a DEXA scan for you, and consider a specialty referral to review your treatment options, because some may involve little more than an annual injection.

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