X-Ray densitometry

Double energy X-ray absortiometics (DXA). It is the “golden standard” for diagnosis of osteoporosis.

Osteoporosis – is a system diseases characteristic of decreased density of bone tissue, decreased mineralization and changes in microarchitectonics of bones, which in turn lead to the risk of low-energy fractures.

Osteoporosis is poly-etiology diseases, and its development is influenced by exchange disorders of calcium, phosphorus, vitamin D; the balance of sexual hormones and medical preparations.

Development of osteoporosis is not expresses clinically, anda patient could encounter only with the consequences thereof, namely with occurrence of fractures typical of such diseases, like:

Double energy X-ray absortiometics (DXA). It is the “golden standard” for diagnosis of osteoporosis. This method joins a range of characterizes, namely: possibility to study almost all bones of a skeleton; high sensitivity and specificity, high accuracy, speed of the study, possible morphological analysis of vertebras for recover deformation changes in case of scanning in side plant.

X-ray absorptiometry allows evaluating clearly the conditions of bone tissue, and on the grounds of numeric values to make a diagnosis and indicate the treatment, if required.

Osteoporosis is subdivided into such types:

Primary

Involutive:

• (1st type) post-menopausal develops in women in post-menopause period (50-65 years); this process in connected with the decrease in the level of sexual hormones (estrogens). Respectively, the main localizations of such fractures are vertebral bodies and distal metaepiphisis of radial bone (fracture of radial bone in typical place).
• (2nd type) senile develops in women and men older than 75 years old. The most frequently, fractures occur in such areas line femoral neck and proximal parts of humeral bones.

Idiopathic:

• Juvenile occurs mostly in children and adolescents under 15 years old. This form is quite rare and is often connected with age of pubertas. In most cases is passes independently and requires only orthopedic correction;
• In the middle age (adult). This diagnosis could be made only after precise examination and lack of reliable and convincing evidence.

Secondary

Caused by somatic diseases:

• Endocrine disorders;
• Disorders of blood formation;
• Genetic disorders;
• Drug administration;
• Diseases of kidneys;
• Digesting disorders and diseases of gastrointestinal tract;
• Other

To make a diagnosis one should perform drug treatment, aimed at:

• Increase of bone mass;
• Prevention of new fractures;
• Improvement of quality of life.

Details before R-n densitometry and defining mineral density of bone tissue (BMD).

- Patients who need total joint replacement: women over 50 years old and men over 60 years old.

- women over 65 years old;

- X-ray densitometry is prescribed for women in post-menopausal age up to 65 years old if case of following risk factors:

• Law body weight (BMI < 19 kg/square meter));
• Fractures in anamnesis of femoral bone, radial bone in typical place “Koles”, humeral neck, compression vertebral fractures).;
• High risk, predetermined by use of drugs (corticosteroids, hormones, cytostatics, diuretics, thromboembolics, heart glycosides, antispastic medicines, antacids with aluminum, preparations based on hormones of thyroid gland;
• Diseases or condition connected with the loose of bone mass.

- Women during menopause with clinical risk factors like low body weight, frequent falling, fractures in anamnesis, increased risk due to consumption of medicines.

- Men aged over 70 years old.

– For men under 70 years old, bone density test is prescribed if they have a risk factor like:

• Low body weight (BWI less that 19 kg/m2);
• A fracture in anamnesis (fracture of femoral neck, radial bone in a typical place, compression vertebral fracture);
• High risk, stipulated by medicines consumption;
• Disease or condition, connected with loss of bone mass.

– Adults with frequent fractures, occurring in connection with frequent falls and low-energy traumas.

– Adults with diseases of conditions connected with low bone mass of loss of bone tissue.

– Adults that use medicines connected with low bone mass or loss of bone tissue.

– A person for whom pharmacologic therapy is considered.

– A person under treatment, to control the efficiency thereof.

– Patients who never undergo anti-osteoporosis therapy with evidences of the loss of bone mass and indications to the respective treatment.

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