Reviewed by: Nick Bryan, MD and PhD
Written by: Abbi Havens
Think about the last time you played Jenga. The game begins with a dense and sturdy tower of blocks. As you remove the blocks, the tower becomes porous, weak and more likely to crumble as it sways back and forth. Eventually, so many blocks are removed that the tower can no longer support itself and collapses. Well, osteoporosis is a lot like Jenga. The disease occurs when your body gets rid of more bone cells than it creates, causing weak and porous bones that are at a higher risk of fracture, particularly in the spine and hips.
At UT Health Austin, we are passionate about a proactive health care approach, which means screenings, screenings and more screenings. That’s why we’ve invested in a state-of-the-art bone density diagnostic machine to determine your risk of breaking a bone before that bone is broken. According to UT Health Austin’s Director of Diagnostic Medicine, Dr. Nick Bryan, MD and PhD, this machine is a gamechanger for developing comprehensive and customized treatment plans for our patients suffering from or at risk of developing osteoporosis.
What is Osteoporosis?
Osteoporosis is a disease in which bone density is reduced and bones become porous (more so than is typical), leaving bones weak and prone to fracture. According to Dr. Bryan, some decrease in bone density is an expected part of the natural aging process.
“Bone goes from cancellous bone (what you and I think of as normal bone) to a bone without strength. As we all get older, we all lose cancellous bone,” says Dr. Bryan. “This is part of the aging process, which affects every organ and tissue in the body.”
Bones are in fact living tissue, and the cells that make up living tissue constantly die and are reproduced. In healthy bones, bone tissue is continuously replaced through a process called bone remodeling (when bone cells begin to dissolve and new bone cells deposit osteoid). In youth and young adulthood, the body produces excess bone cells faster than existing cells need to be replaced. The resulting excess of bone cells keeps bones strong and dense. Your bones reach their peak of density in your mid-twenties. In your mid-thirties to forties, bone cells begin to die faster than new bone cells are produced, thus beginning the slow decline of bone mass. If this process occurs at an excessive rate, a person is at risk of developing osteoporosis.
Because signs of osteoporosis often do not appear until a bone breaks, screenings are critical to assessing your risk of osteoporosis and fracture. However, a stooped spine may indicate osteoporosis.
“One of the most common things that you see with osteoporosis, particularly in older women, is the spine developing a stooped configuration,” says Dr. Bryan. “This is because as stacked vertebrae in the spine become porous, the weight from stacking causes vertebrae to fracture, resulting in a forward stoop of the spine.”
According to Dr. Bryan, exercise, exercise and more exercise is key to preventing osteoporosis later in life.
“The more active you are and the more force you place on your bones, the more your bones react to be strong and able to resist that force,” says Dr. Bryan. “Typically, the older you get, the less active you become. Every-day pressure is removed from the bone causing osteoporosis to develop. When more osteoporosis develops, you may get a fracture which will make you even less active, encouraging osteoporosis to continue to develop further. It’s a cycle, and exercise is the key to breaking it, or preventing it from beginning in the first place.”
Of course, exercise is not the only treatment for osteoporosis. Medications, most commonly bisphosphonates, slow down the process of bone breakdown to slow or stop the progression of osteoporosis. In some case, bone density is regained as a result of medication. Physical and occupational therapy also play a role in the treatment of osteoporosis.
About the Machine
UT Health Austin’s new bone density diagnostic machine, the GE Lunar DXA to be exact, immediately provides our team of experts with the data and imaging they need to make an assessment and develop a treatment plan customized for each patient.
“The new machine is state-of-the-art,” says Dr. Bryan. “A patient comes in for a screening, lies flat, and receives a very low dose of x-ray so there is no risk or pain to the patient. In a matter of minutes, data and images go straight to the radiologist who will conduct the final analysis and interpretation and suggest appropriate treatment options.”
In the simplest terms, the machine measures the amount of “good bone” you have left and provides the radiologist with a bone density score, which is adjusted for sex and age. Patients who are below a certain bone density score may be at a higher risk for fracture. The new machine captures extra-crisp images with enhances precision and is able to detect small but significant changes sooner, allowing for preventative and proactive care.
What’s the best part of the new bone density diagnostic machine, according to Dr. Bryan? Convenience.
“Study after study shows that if a screening is inconvenient, patients are far less likely to get it, leading to major health complications down the road,” says Dr. Bryan. “Patients can walk right up to our machine on the 9th floor, get a scan right then and there, and leave with results within a matter of minutes. Additionally, the GE Lunar DXA is right next door to our new mammography machine! So patients who are most at risk of osteoporosis (women over the age of 65) can receive a mammogram and bone density test in one convenient trip.”
Adults over age of 65 (particularly women) or any person who has reason to be concerned about osteoporosis including those suffering from certain cancers or diseases that result in bone loss, can get a bone density screening on a walk-in basis. Because the machine is more automated than ever before, patients receive better results at a fraction of the cost. At UT Health Austin, we encourage you to take control over your health! Be proactive and ask your doctor if you could benefit from a bone density screening.