EXAMINATION:  BONE DENSITOMETRY OF THE SPINE AND HIP

DATE OF STUDY:  

HISTORY:

FINDINGS (SPINE):  The bone mineral density of L1-L4 was
assessed by dual-energy x-ray absorptiometry.  The average bone
mineral density within this region is ------ gm/sq-cm.  This is
--- standard deviations ---- the mean of the average bone mineral
density for age-and gender-matched subjects (the Z-score).
It is --- standard deviations ---- the mean peak bone mineral
density in young adults (the T-score).

FINDINGS (FEMORAL NECK):  The bone mineral density of the left
femoral neck was assessed by dual-energy x-ray absorptiometry.
The average bone mineral density within the femoral neck region
is ------ gm/sq-cm.  This is --- standard deviations ---- the mean of
the average bone mineral density for age-and gender-matched subjects
(the Z-score).   It is --- standard deviations ---- the mean peak bone
mineral density in young adults (the T-score).


FINDINGS (TOTAL HIP):  The bone mineral density of the left hip
was assessed by dual-energy x-ray absorptiometry.  The average
bone mineral density within the total hip region is is ------
gm/sq-cm.  This is --- standard deviations ---- the mean of the
average bone mineral  density for age-and gender-matched subjects (the
Z-score).   It is --- standard deviations ---- the mean peak bone
mineral  density in young adults (the T-score).


SUMMARY OF CURRENT RESULTS:
-----------------------------------------------------------------
Region  Exam Date     BMD  T-Score  Z-Score
-----------------------------------------------------------------
AP Spine(L1-L4)     
Femoral Neck(Left)  
Total Hip(Left)     



OPINION:

1.  The bone mineral density of the lumbar spine is ----

2.  The bone mineral density of the left femoral neck is ----

3.  The bone mineral density of the left total hip is ----

4.  Overall, the above findings are indicative of  ----  by WHO criteria.



General comments regarding interpretation of bone mineral
density measurements:

a) In children, premenopausal women and males under age 50 not
at increased risk for fractures only Z-scores, not T-scores are
used to indicate risk.  A Z-score above -2.0 is defined as
"within the expected range for age" and Z-score at or less than
-2.0 is "below the expected range for age".  A Z-score below the
expected range for age in a patient with recent fractures and/or
chronic corticosteroid treatment is consistent with a diagnosis
of osteoporosis.

b) In post menopausal women and males over 50, comparison of the
measured bone mineral density with the average value in young
normal subjects (the "T-score") has been found to be useful in
assessing fracture risk.  Fracture risk approximately doubles
for each 1.0 standard deviation (SD) in individual's hip or
spine bone mineral density is below the average value of young
normal subjects.  The World Health Organization (WHO) has
defined T-scores of -1.0 to -2.5 as indicative of low bone mass
(OSTEOPENIA), and T-scores of -2.5 or lower to be indicative of
OSTEOPOROSIS, based on the site of lowest bone density.

Note that there will be a change in reporting format and
reference databases as patients move from the younger population
(group a) to the older population (group b).

The National Osteoporosis Foundation (www.nof.org) recommends
adequate intake of calcium and vitamin D and regular
weight-bearing exercise in all patients.  In Caucasian
postmenopausal women, the NOF recommends treatment with
pharmacologic therapy if the T score is below -2.0.  Treatment
might also be considered if the T-score is between -1.5 and -2.0
in patients who are at higher risk (e.g., personal history of
fracture as an adult, history of fragility fracture in a
first-degree relative, low body weight (< about 127 lbs),
current smoking, or use of oral corticosteroid therapy for more
than 3 months).  Guidelines for treatment of osteopenia alone in
other racial groups, men, and premenopausal women are not
available, but treatment should definitely be considered if the
bone density reaches the level of osteoporosis (T-score below
-2.5).