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
Osteopenic Femur BMD
Femoral Neck BMD T-score: -1.5
Total Hip BMD T-score: -1.3
Low TBS value
Spine TBS (L1-L4): 1.073
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).