Osteoporosis ~ Diagnosis

Osteoporosis ~ Diagnosis
To diagnose Osteoporosis we have to find out the calcium content of the bones. To put it more scientifically, the Bone Mineral Density ( BMD) has to be evaluated. The technology that is used to do this is known as Bone Densitometry.
Before the advent of BMD tests, osteoporosis was diagnosed by routine X-rays or by bone biopsy. By these methods osteoporosis could be rarely diagnosed before at least 25 % of the bone mass was lost, and by this time the disease is well advanced. Today BMD tests help in diagnosing the disease and also help in warning us from the likely hood of developing osteoporosis in the near future.
Indications for BMD tests
1. At Menopause, to decide regarding the need for Hormone therapy.
2. Those on glucocorticoids, to see if they are losing bone mass or not.
3. Recent fractures, where osteoporosis is suspected.
4. Those with osteoporosis and under treatment, to monitor the effectiveness of treatment.
5. Those with Primary Hyperparathyroidism.
6. A man with Hypogonadism.
7. Those on chemotherapy and may be losing bone mass.
The most common bone density test in use today is called  dual energy x-ray absorptiometry (DXA).
It is a non invasive procedure and the amount of radiation exposure is very little.The results are expressed in units referred to as standard deviations (SD). These SD units tell how far you differ (or deviate) from what is considered normal. If you are 2.5 SD units below normal (-2.5), you will be told that you have osteoporosis.
Heel Ultrasound: A new Technology for testing Bone Density
The test usually involves immersing your foot in a bath of warm water, allowing high frequency sound waves to pass through your heel. The test measures the density and quality of the bone in your heel. It has not yet become a standard testing procedure.

Diagnostic Classifications of Osteoporosis

Classification Definition Risk and Recommendations
Normal BMD is not more than -1 SD below the average peak bone mass of a young person (30-45) Risk of fracture is very low.
Low Bone Mass (sometimes referred to as Osteopenia) BMD is between 1 and 2.5 SD below normal (between 1 and 2.5) • Risk of fracture is usually low to moderate.
• Accelerated bone loss at menopause requires immediate intervention.
Osteoporosis BMD is greater than 2.5 SD below normal (-2.5) and there have been no fractures • Moderate to very high risk of fracture.
• Treatment is advised .
Severe Osteoporosis BMD greater than 2.5 SD below normal (-2.5) with existing fractures • Very high to extremely high risk of fracture.
• Treatment is strongly advised.

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