Introduction
Osteoporosis is a bone-related condition in which the bones shrink and weaken. Bones become less thick and more brittle as a result, increasing the likelihood of breaking. Unfortunately, osteoporosis may not show symptoms until a break happens, so it is also referred to as "the silent disease. Early identification can have a significant impact on the prevention and treatment of osteoporosis. Primary testing for osteoporosis involves measuring bone density, or how strong a person's bones are. Dual-energy X-ray absorptiometry, or DXA is one of the most commonly utilized scans to assess bone health and fracture risk related to osteoporosis.
Why Is Early Diagnosis of Osteoporosis Important?
The number of people who have osteoporosis has been estimated to exceed 200 million worldwide, and both its prevalence and awareness have increased in recent years. However, approximately 75 percent of these individuals are undiagnosed cases who do not receive the necessary care. Osteoporosis-related fractures cause significant rates of death and disability, lower life quality, and a dramatic rise in healthcare expenses.
Thus, osteoporosis and the resulting fragility fractures are a major health issue for elderly women (older than 50), and this number will rise in the next decades due to the progressive growth in life expectancy in industrialized countries. For individuals who are at risk of osteoporotic fractures to be identified and treated on time, early diagnosis is crucial.
The two main goals of osteoporosis diagnostic imaging are to detect osteoporosis and use bone mass quantification to obtain prognostic information on the likelihood of future fractures. Osteoporosis diagnosis is based on BMD (bone mineral density) measurement, which is now thought to be the most accurate indicator of osteoporotic fractures. The BMD value is the amount of bone mass per unit area (areal density) or per unit volume (volumetric density).
In the last 25 years, several non-invasive techniques for diagnosing osteoporosis have been created. These techniques use the attenuation of ionizing radiation to measure bone mineral density (BMD) at various skeletal locations. Among the most often utilized X-ray-based technologies, quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) are capable of measuring bone loss, whereas morphometry can detect the occurrence of vertebral fractures.
What Is a Bone Density Scan?
The amount of minerals, such as calcium, in the bones, is determined by a bone density test. The likelihood of a fracture increases with decreasing bone density. Bone density is the most precise fracture risk assessor and osteoporosis identification method currently available. DXA uses a small amount of radiation (10 percent of a typical chest X-ray). It is painless and takes around 10 minutes. QCT, or quantitative computed tomography, is an alternative imaging technique to DXA.
To ensure that the positioning is accurate, the patient has to lie on a DXA table and obey the technologist's directions. Following that, a moveable arm looks over the head to examine the skeleton. DXA is most frequently used on the hips and lower back. A full body scan may be performed on certain adults and children. Sometimes, low bone mass can be screened with peripheral devices that use ultrasound or X-ray technology, usually at the forearm. In certain localities, decreased bone mass can also be diagnosed or tracked using a CT scan with specialized software. This method is accurate but less popular than DXA scanning.
What Are the Advantages of DXA?
The amount of minerals, such as calcium, in the bones, is determined by a bone density test. Dual-energy X-ray absorptiometry (DXA) is the most widely used and adaptable test. This is used to detect osteoporosis before bone breakage, assess the likelihood that one may break a bone in the future, and track how well osteoporosis medications are working. It just takes a few minutes to complete this test. There are no needles or other objects inserted into the body or skin during the non-invasive, painless examination. Radiation levels are extremely low.
Who Should Have a Bone Density Scan?
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Women aged 65 years or older.
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Men who are 70 years of age or older.
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Anybody who has fractured a bone after the age of fifty.
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Women aged 50 to 64 with risk factors.
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Men with risk factors who are 50 to 69 years old.
A few risk factors for osteoporosis and fractures are smoking, excessive alcohol consumption, malabsorption, vitamin D insufficiency, frequent falls, a familial history of osteoporosis or fractures, and use of certain drugs, such as Prednisone.
How Can One Interpret DXA Results for Understanding Bone Density and Osteoporosis Risk?
The T-score is the number used for diagnostic classification for postmenopausal women and males 50 years of age and older.
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A bone density T-score of -1.0 or higher is considered normal.
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If one has poor bone mass, the T-score falls between -1.0 and -2.5.
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Osteoporosis is diagnosed when a T-score of -2.5 or below is obtained.
It is crucial to understand that if the T-score is greater than -2.5, one may be diagnosed with osteoporosis. This can also happen in case one has previously experienced a broken bone. Additionally, it is possible to have a disease other than osteoporosis, such as multiple myeloma or osteomalacia, if the T-score is 2–5 or lower. The doctor can assess patients to confirm the diagnosis or can recommend a qualified specialist if necessary.
Conclusion
Osteoporosis is becoming more common as the world's population ages, and its complications impose a heavy social and financial strain on society. Accurate and timely diagnosis of osteoporosis may result in better clinical care, including prevention and appropriate pharmacological or surgical treatment. Early diagnosis of osteoporosis and other bone disorders is possible with routine screening. With prescription medicine and lifestyle changes, they can then be controlled and even reduced. A dual X-ray absorptiometry scan can identify osteoporosis even in the absence of a fracture and can assist in estimating the likelihood of future fractures. It can also identify the various low-density bones in the body and determine the rate of bone loss.
