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TBS & Patient Management

By Dr Gerardo Aguilar, General Practitioner & Clinical Densitometrist Clinica Bajio Clinba, Guanajuato, México

Patient Clinical Background

This is a 63-year old woman who was referred for bone density testing, with the following important medical backgrounds:

  • mother with forearm history fracture,
  • no previous fracture,
  • regular calcium and vitamin D intake,
  • hysterectomy at age 41 (no oophorectomy).

Bone Assessment & Analysis Images

Osteopenic Spine BMD
Spine T-Score (L1-L4 ): -1.4

TBS & Patient Management - Medimaps Case Study 1 - Osteopenic Spine BMD

Osteopenic Femur BMD
Femoral Neck BMD T-score: -1.5
Total Hip BMD T-score: -1.3

TBS & Patient Management - Medimaps Case Study 1 - Osteopenic Femur BMD

Low TBS value
Spine TBS (L1-L4): 1.073

TBS & Patient Management - Medimaps Case Study 1 - Low TBS value

Conclusion & Patient Management Decision

FRAX® result: 4.7% for major osteoporotic fracture, 0.8% for hip fracture.

CAROC assessment: Low risk fracture.

However TBS score was reported as degraded (below 1.200).

FRAX® Adjusted for TBS: 7.5% for major osteoporotic fracture; 1.52% for hip fracture.

Based on clinical risk fracture of the patient our recommendation was to assure an adequate calcium intake as well as Vitamin D, and a training exercise for bone strength.

Referral physician decided to start anti-resorptive treatment (Risedronate 5mg daily).

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