The risk of fragile bones

preventing OP before it develops is possible, and is a much more desirable option.

Identifying at-risk’ people can be done using bone density imaging, called a DEXA scan. This test tells if you have normal bone density, low bone density (osteopenia, which is a precursor to OP) or osteoporosis. The lower your bone density, the greater the risk of breaking a bone. A DEXA scan can help your doctor:

Find out if you have OP before you break a bone

Predict your future risk of breaking a bone.

Monitor your bone density over time.

Assess how well an osteoporosis medication is working.

The scan is simple, pain-free and takes less than 15 minutes. It takes only tiny amounts of radiation (about the same as you would absorb from the environment in an average day), and is a highly precise test. The best results are obtained if the same machine is used each time you need a DEXA scan.

If a DEXA scan shows you are at risk of OP, your doctor will talk to you about appropriate management. Depending on the level of risk, the options might include:

Lifestyle changes – altering diet, exercise, smoking status and alcohol intake can improve your bone density.

Vitamin D – using vitamin D supplements, especially over winter, can have a positive effect as well, especially in people who don’t get much daily sunlight exposure.

Falls prevention – if you have OP, reducing your risk of falls (via programmes such as tai chi or pilates) is an important part of management.

Medication – oral or intravenous drugs are available that can maintain or even improve your bone density.

If you fall into a ‘‘high risk’’ category, or have already had a ‘‘low-impact’’ fracture (a broken bone after a fairly minimal injury), you should consider getting a bone density scan. Unfortunately, it is almost impossible to get a free scan – something I would dearly love to see the Ministry of Health reconsider. The cost is about $150 – unaffordable for many – but when compared with the $300m it costs the government to treat the effects of OP, I would have thought the costbenefit ratio of a funded, targeted screening programme was hard to argue.