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 loosing 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.
|
| |
|
|
|
|
