Bone mineral density scans in veterans

Figures & data

Table 1 General risk factors for osteoporosis in men

1.	Personal history of fracture after age 50
2.	History of fracture in a 1st degree relative
3.	Current low bone mass
4.	Being thin and having a small frame, or both
5.	Advanced age
6.	A family history of osteoporosis
7.	Low lifetime calcium intake
8.	Vitamin D deficiency
9.	Use of certain medications (corticosteroids, chemotherapy, anticonvulsants and others)
10.	Presence of certain chronic medical conditions
11.	Low testosterone levels in men
12.	An inactive lifestyle
13.	Current cigarette smoking
14.	Excessive use of alcohol
15.	Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

Adapted with permission as excerpt from http://www.nof.org/osteoporosis/diseasefacts.htm,

The National Osteoporosis Foundation, Washington DC 2007. All rights reserved.

Table 2 Annual scan procedures (CPT codes) by gender

	Number performed (percent)*
	FY2001	FY2002	FY2003	FY2004
Male
CT Bone Density, Axial (76070)	47 (8)	83 (9)	187 (19)	326 (26)
DXA, Axial (76075)	493 (86)	806 (89)	760 (77)	912 (72)
DXA, Appendicular (peripheral) (76076)	32 (6)	⋄ (2)	34 (3)	32 (3)
Total	572	907	981	1,270
Change from previous year		59%	8%	29%
Female
CT Bone Density, Axial (76070)	47 (5)	52 (7)	70 (10)	130 (20)
DXA, Axial (76075)	896 (93)	641 (91)	606 (86)	502 (78)
DXA, Appendicular (peripheral)	⋄	⋄	⋄	⋄
(76076)	(2)	(2)	(4)	(2)
Total	960	708	701	644
Change from previous year		–26%	–1%	–8%
Total scans (both genders)	1,532	1,615	1,682	1,914
Percent male	37%	56%	58%	66%

Note: *Percentages may not equal 100 due to rounding; n = 6,743;

⋄ The exact number (and percent) less than 30 not reported; sourced from VistA with calculations by the authors.

Abbreviations: CPT, common procedure terminology; CT, computed tomography; DXA, dual-energy X-ray absorptiometry, FY, financial year.

Figure 1 Bone mineral density scans for males, 2001–2004.

Note: n = 3,730; sourced from VistA with calculations by the authors.
Abbreviations: CT, computed tomography; DXA, dual-energy X-ray absorptiometry, FY, financial year.

Table 3 Age distribution (percentages)* by gender of scan recipients by first and last year of study, including four year annual average

Males	FY2001	FY2002	FY2003	FY2004	Average
under 40	3.3	2.8	2.1	2.5	2.7
40–49	8.9	9.1	7.85	7.4	8.3
50–59	22.9	21.1	21.4	19.5	21.2
60–69	25.7	23.5	24.9	21.7	23.9
70–79	28.9	29.2	31.0	31.2	30.1
80 and over	10.3	14.3	12.7	17.7	13.8
Sample size	572	907	981	1,270
Females
under 40	2.0	1.55	2	2.8	2.1
40–49	13.2	19.9	17.4	17.7	17.1
50–59	33.2	33.9	35.5	42.4	36.3
60–69	25.7	21.9	21.7	19.7	22.3
70–79	17.7	15.7	14.3	8.9	14.1
80 and over	8.1	7.1	9.1	8.5	8.2
Sample size	960	708	701	644

Note: *Percentages may not equal 100 due to rounding; sourced from VistA with calculations by the authors.

Abbreviations: FY, financial year.

Figure 2 Trends for male scan recipients by age, 2001–2004.

Note: sourced from VistA with calculations from the authors.
Abbreviations: FY, financial year.

Table 4 Scan patients (%)* receiving drugs with potential bone-loss side effects 2001–2004

Medication	Males	Females
Steroids	36%	26%
Anticonvulsants	30%	21%
Gabapentin (enzyme noninducing)	26%	19%
Dilantin (enzyme inducing)	8%	4%
Thyroid	10%	22%
Methotrexate	7%	3%
Heparin	5%	2%
Heparin	3%	1%
Low molecular weight Heparin	3%	1%
Cyclosporine A	2%	0%
Antiandrogen	2%	0%
Cholestyramine	0%	0%

Note: *Possible multiple medications per patient: percentages do not total 100; n = 4,919; sourced from VistA with calculations from the authors.