Title: Using T-scores as evidence: A case study.

Submitted By: Lawrence G. Jankowski, CBDT
Quarterly Cases Editor

Patient History:

A 66 yr. old female who has had several thoracic compression fractures from a fall in the bathtub, and osteoporosis by DXA, along with a history of GERD, is offered either yearly infusions of zoledronic acid, or denosumab, and is given information on both, and asked to return in several weeks to review a series of lab tests (vitamin D, PTH, TSH, CBC, and metabolic panel), and discuss her options.

Upon return, she states she is terrified of the potential side effects of both options and would like to try a “more natural approach”. To that end, she presents with several pages of natural options and was particularly interested in one program that included the following DXA scan evidence of success (Figure 1).




Figure 1: Femur neck T-scores from two scans taken less than a year apart, of the author of a natural osteoporosis program. (Source: https://saveourbones.com/osteoporosis-reversal-program/, accessed 2019)

Questions:

  1. Assuming T-scores presented are of the femur neck, and that there are no technical errors in DXA scans that generated them, how does this represent a 20% improvement in bone mineral density?
  2. Can you calculate the increase in bone mineral density in grams per square centimeter from the information provided in figure 1?

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