Osteoporosis through DEXA Bone Densitometer
“Osteoporosis” A silent disease is a serious health problem
What is Osteoprosis?
Osteoporosis is a disease characterized by low bone mass & structural deterioration of Bone Tissue that compromises bone strength & predisposes one to increased fracture risk. While Osteoporosis affects all population & ages, post-menopausal females or males beyond 50 years of age are the most susceptible & require major attention.
Prevalence:
Osteoporosis is a disease of epidemic proportions affecting millions of people in India alone, a majority of these being women. However, men too are affected by this disease.
Symptoms:
Osteoporosis is often called the “silent disease” because bone loss occurs without symptoms. People may not know that they have Osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture. In fact a vertebral fracture can cause a spine collapse and lead to significant pain, height loss & stooped posture. The risk of hip fracture due to Osteoporosis in women is larger than the sum of the risk of developing breast, uterine & ovarian cancer!
Detection:
According to WHO, the best criteria for the diagnosis of Osteoporosis, is the measurement of Bone Mineral Density (BMD).
A Bone Density Test can do the following:
1. Detect Osteoporosis before a fracture occurs.
2. Predict ones chances of fracturing in the future.
3. Determine rate of bone loss and/or monitor the effects of treatment.
DEXA (Dual Energy X-Ray Absorptiometry)
is considered the “gold standard” among several techniques that provide an accurate BMD assessment of multiple skeletal sites. A strong correlation has been proven to exist between hip & spine BMD scores & the risk of fractures.
Risk factors for Osteoporosis & Indications for Bone Densitometry:
(a) Post-Menopausal Women:
Estrogen (a protective hormone against bone loss) decreases rapidly after menopause, Hence, women experience more rapid bone loss in early years following menopause (can lose up to 20% of their bone mass in the 5-7 years following menopause) which places them at increased risk of fractures.
(b) Advanced Age:
Maximum bone density is attained between age of 20-30 years. After 30, as the person grows older, there is a gradual loss of bone density & strength. Bones become more porous, weaker & fragile. This increases the risk of fracture. 1 in every 4 women over 50 years of age & 1 in every 8 men over 50 years are believed to have Osteoporosis.
(c) Medications & medical Conditions:
Cortisone like drugs (Steroids) given for medical conditions such a arthritis & asthma can increase bone loss as can certain anticonvulsant drugs, excessive dose of thyroid hormones, hyperthyroidism & prolonged immobilization following injury or surgery.
Other risk factors include:
(d) Lack of Exercise
(e) Low calcium Diet
(f) Use of Cigarettes and Alcohol
(g) A small/thin frame
(h) Family history of Osteoporosis
(i) Race (Asian women are at special risk for developing Osteoporosis)
Applications for Total body DEXA :
- Weight-reduction treatment.
- Growth hormone treatment
- Primary hyperparathyroidism.
- Anabolic steroids therapy.
- Anorexia nervosa.
- Cushing’s syndrome.
- Exercise.
- Muscular dystrophy.
- Cachexic disorders (AIDS, Cancer)
- Malabsorption syndromes.
Why should I prefer only DEXA Bone Densitometry?
All over the world DEXA is considered the “Gold Standard” for precise assessment of bone density, having a significantly better accuracy & precision over other modalities like Ultrasonographic Densitometry, X-Rays, Osteo CT or laboratory investigations.
Why DEXA?
1. It measures BMD (Bone Mineral Density), which according to WHO, is the best criteria for the diagnosis of Osteoporosis.
2. DEXA results are very precise, accurate & consistent.
3. It measures BMD at those sites which are clinically most relevant (e.g. Femur, Wrist & Spine).
Femur is the most sensitive site for predicting Osteoporosis. Spine is the most sensitive site to monitor the response to therapy. 4. Total body DEXA gives exact fat and lean tissue assessment of body. This is vital in Slimming Programmes/ Weight Reduction/ Obesity Management/ Growth Hormone Therapy.