Introduction
A special computed tomography (CT) scan can determine the bone density of the hip or spine. Decreased bone mass leads to more brittle bones that are prone to pathological fractures.
To diagnose osteopenia and osteoporosis, a bone density test is done, thus helping determine the future risks of fracture. The procedure measures the bone density of the spine, lower arm, and hip bones. Portable testing methods may use the radius, wrist, fingers, or heel, but the results are questionable.
The X-ray images may show weakened bones; however, the bones may be well on their way to more significant damage by the time a radiographic interpretation is possible.
How Is Bone Density Tested, and What Do the Results Show?
A bone density is used to determine the bone mineral density, abbreviated as BMD, which is compared to 2 norms;
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Healthy young adults (T-score)
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Age-matched adults (Z-score).
BMD result is compared with that of 25 to 35-year-old adults of the same sex and ethnicity. The standard deviation (SD) is calculated as the difference between the BMD of the tested person and healthy young adults, which is the T-score.
When T-scores are positive, it indicates that the bone is more robust than average, whereas a negative T-score means the bone is weaker than average.
The World Health Organization defines osteoporosis on the following bone density levels;
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A T-score within 1 SD indicates bone density to be within normal limits.
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A T-score of -1 to -2.5 SD shows low bone mass and is prone to future osteoporosis and osteopenia.
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A T-score of -2.5 SD or below indicates the presence of established osteoporosis.
The risk for pathological fractures doubles with every SD below normal. Thus, a person with a T-score of -1 has twice the risk for bone fracture. BMD is also compared to an age-matched norm called Z-score, where comparisons are made to someone of the same age, sex, race, height, and weight.
When Is Bone Density Testing Needed?
A bone density test is done to diagnose osteoporosis, which causes thin, weak bones, and osteopenia, which causes a decrease in bone mass. The complications of osteoporosis-related pathological fractures are often severe, particularly in elderly patients. Early diagnosis of osteoporosis leads to prompt treatment, and this can either improve the condition or at the very least keep it from deteriorating. Decreased bone mass makes it more brittle and is prone to pathological fractures. To diagnose osteopenia and osteoporosis, a bone density test can be performed, thus helping determine the future risks of fracture. The procedure measures the bone density of the spine, lower arm, and hip bones. Portable testing methods may use the radius, wrist, fingers, or heel, but the results are questionable.
A bone density testing is thus done for the following reasons;
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Diagnose osteoporosis if there is a history of bone fracture.
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Predict the chances of fracturing a bone in the future.
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Determine the rate of bone loss.
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Evaluate the success of the treatment.
What Are the Risk Factors for Reduced Bone Density?
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Aged women not taking estrogen supplements.
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Aging, women over 65 and men over 70.
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Smoking tobacco.
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Family history of hip fracture.
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Using long-term steroids or certain other medicines.
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Type 1 diabetes mellitus.
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Liver disease.
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Kidney disease.
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Hyperparathyroidism.
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Excessive alcohol consumption.
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Low BMI (body mass index).
What Is Peak Bone Mass?
The maximum bone size and strength reached during an individual's lifetime is called peak bone mass. The role of genetics is significant in determining the peak bone mass, alongside lifestyle factors like diet and exercise. It influences the peak bone mass of an individual. The ideal time to build up bone density is during the phase of rapid growth in childhood, adolescence, and early adulthood. Activities such as smoking, poor nutrition, inactivity, and excessive alcohol intake can decrease the potential for reaching this peak bone mass.
Most individuals reach peak bone mass between the ages of 25 and 30. By age 40, the body slowly begins to lose bone mass. However, several steps to avoid severe bone loss over time can be taken, and the rate of bone loss can be significantly retarded through a regimen of proper nutrition and regular exercise. People who develop higher peak bone mass during their early years are better protected against osteoporosis, osteopenia, and related pathological fractures.
However, specific individuals are more prone to bone loss and osteoporosis because of the altered bone remodeling process, which removes old bone and replaces it with new bone. A regimen of healthy diet and strengthening exercises can help, but the rate of bone loss cannot be compensated. However, recent advances in medications have been developed to treat this metabolic problem, and in some cases, bone loss may even be reversed.
How Does Gender Influence Peak Bone Mass?
Men have higher peak bone mass than women as they accumulate more skeletal mass during growth, and the bone width and size are more significant than that of females of the same age and race. Women have smaller bones with thin cortices and smaller diameters, which causes them to be more vulnerable to developing osteoporosis in later years. However, men have higher peak bone mass but are not spared from the risk of osteoporosis. Around 70 years, the risk of bone loss and pathological fractures increases significantly among men. Purchasing walking boot for broken foot can be useful in fractures of the leg.
Conclusion
Dual-energy X-ray absorptiometry, often known as DEXA or DXA, is a technique that uses X-rays to measure the density and mineral content of bones. The density of the spine's or the hip's bone can be assessed using a specialized computed tomography (CT) scan. Less bone mass makes bones fragile and more vulnerable to pathological fractures. A bone density test can be used to identify osteopenia and osteoporosis and assist or predict future fracture risks. The procedure evaluates the spine, lower arm, and hip bones' bone densities. The outcomes of portable testing procedures using the radius, wrist, fingers, or heel are dubious.
