Evaluation of Bone Health

Question 1

Turnover rate of cortical bone and trabecular bone

Answer 1

Cortical: 2-3% per year
Trabecular: higher than cortical

Question 2

When is the peak bone mass for

1. Trochanter
2. Femoral neck
3. Spine

Answer 2

1. ~14 (mid teens)
2. ~18.5 (late teens)
3. 23 (early 20s)

Question 3

Rates of bone loss for

1. Age related bone loss
2. Menopause

Answer 3

1. 0.5-1% per year

2. 1-2% per year

Question 4

How long does it take for bone to get mineralized

Answer 4

10-12 weeks

Question 5

3 ways to measure bone quality

Answer 5

High resolution peripheral qualitative CT
Trabecular bone score
Bone microindentation testing

Question 6

High resolution peripheral quantitative CT (HRpQCT)

Answer 6

Specialized CT of the peripheral skeleton (distal radius and tibia)
Very high resolution (virtual biopsy)
Non-invasive

Question 7

Trabecular bone score (TBS) scoring

Answer 7

1.35 + (normal)
1.20 to 1.35 (partially degraded)
< 1.20 (degraded)

Question 8

3 sites a DXA (dual energy Xray absorptiometry) scan looks at

Answer 8

Lumbar spine
Total hip
Femoral neck

Question 9

T score for

1. Normal
2. Osteopenia
3. Osteoporosis

Answer 9

1. Equal to -1.0 or higher
2. Between -1.0 and -2.5
3. Equal to -2.5 or lower

Question 10

When should you treat for osteoporosis based off the NA menopause society guidelines?

Answer 10

Postmenopausal women and men over 50 with 1 of :
A hip or vertebral fracture
T-score less than or equal to -2.5 after excluding secondary causes
Osteopenia but a 10 year probability of hip fracture 3% or of any osteoporosis fracture 20%+