 This month we feature Dr Ismail , who completed his MBBS in Stanley Medical College. Diploma in orthopedics from Tanjore Medical College and MS in orthopedics from Madras Medical College.
His areas of special interests are Joint and Spine rehabilitation and Trauma Care.
With so much awareness being created about osteoporosis and osteopenia, when should a person ideally get his or her bone density tested?
Typically at the age of 50, a DEXA Scan should be done. If fragility in the bones is suspected by repeated fractures and bone pain, than the test should be done earlier.
It is considered the most accurate test for bone density. While standard x-rays show changes in bone density after about 40% of bone loss, a DEXA scan can detect changes after about a 1% change. A DEXA scan lasts about 10 minutes, and exposes the patient to less radiation than a standard chest x-ray.
The results of a bone density measurement (DEXA scan) are usually reported as T-scores.
A T-score compares the bone density of the person to the optimal peak bone density for the respective gender.
It is reported as number of standard deviations below the average.
A T-score of greater than minus-1 is considered normal. A T-score of minus-1 to minus-2.5 is considered osteopenia, and a risk for developing osteoporosis. A T-score of less than minus-2.5 is diagnostic of osteoporosis.
Why does one develop Osteoporosis?
The osteoporosis results due to weakening of the bones .The bones become weak due to deficiency of Vitamin D and Calcium.
The Vitamin D is synthesized by our body in the presence of sunlight. Even in our country with so much sunshine we suffer Vitamin D deficiency as the exposure is inadequate. For the body to synthesis adequate Vitamin D the hands, legs and face should be exposed for a period of forty five minutes between 1 and 3 pm.
It is advisable to take a 400 IDU of Vitamin D and 500 mg of Calcium Supplement at the age of 35 and increase it to 800 IDU of Vitamin D and 1gm of Calcium at the age of 45.
What is a Joint replacement surgery which we often here?
Joints (where two or more bones come together, like the knee, hip, and shoulder) can be damaged by obesity, diabetes, deficiency of Vitamin D and Calcium, arthritis, infection or injuries. Aging can cause the joint to wear away. This can cause pain, stiffness, and swelling.
Joint replacement surgery is removing a damaged joint and putting in a new one. A new joint, called prosthesis, made of plastic, metal, or both is fixed. This tremendously improves the quality of life.
The Joints that largely require replacement are the Hip and Knee Joints which are load bearing joints.
What can one do to preserve the Bones?
A balanced diet may provide adequate calcium, but vitamin D deficiency is equally responsible for bone loss. So it is prudent to take the recommended oral supplements.
A regular strength and weight training exercises as well as weight bearing exercises can improve the bone density. As the muscle and bones together form the musculoskeletal system.
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