Use of Bone Mineral Density assessment in Brunei Darussalam
Arrianne Mae PADUA 1, Kian Chai LIM 1, Ketan PANDE 2
1 Department of Radiology and 2 Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Brunei Darussalam
ABSTRACT
Introduction: Clinical practice guidelines from various health organisations are available for use of Bone Mineral Density (BMD) testing using Dual Energy Xray Absorptiometry (DXA) in osteoporosis. The purpose of this audit was to study the referral pattern for BMD testing in Brunei Darussalam. Material and Methods: Data was extracted from the referral form for DXA stored in a Department of Radiology computer database. This information was used to obtain the total number of patients undergoing DXA from 2009 to 2014 with their age, sex and source of referral. Additional information was available for patients referred from the Department of Orthopaedics in 2013-2014. The T-score of BMD is expressed as mean ± SD. The statistical analysis was done using SPSS version 17.0. Results: The total number of patients undergoing DXA was 820. More women than men were referred and maximum numbers of patients were in the 6th and 7th decade of life. The most common sources of referral were Rheumatology, Endocrine, Orthopaedic and Internal Medicine clinic. A total of 51 patients (Male 7, Female 44) were referred from the Department of Orthopaedics in 2013-2014. The most common reason being osteoporosis seen on radiographs (n=16), fragility fracture (n=8) and post-menopausal status (n=7). The BMD T-score at lumbar spine and hip in patients referred with fragility fracture and radiological osteoporosis was significantly lower than those referred for other indications. Conclusions: Compared to the international recommendations and the likely number of subjects at high risk of osteoporosis, BMD testing is underutilised in Negara Brunei Darussalam particularly in men and in patients with fragility fractures.
Keywords: Osteoporosis, Bone Mineral Density, DXA, Fragility fracture
Correspondence author: Ketan C PANDE, Department of Orthopaedics, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam. Tel: +673 2242424, Fax: + 673 2242690, E mail: ketanpande@yahoo.com
Brunei Int Med J. 2015; 11 (6): 303-309