Densitometry: X-ray diagnosis of osteoporosis

Densitometry (diagnosis of osteoporosis)

Osteoporosis is an extremely common disease characterized by a decrease in bone density.

To a certain extent, the increasing incidence of diagnosed cases of osteoporosis is due not so much to deterioration of health status of the population, but an increase in life expectancy (the disease affects mainly people in the older age group).

A certain role in increasing the number of patients with increased fragility of bones was played by the development of diagnostic capabilities of modern medicine.

The most informative method for conducting osteoporosis diagnosis is bone densitometry, which allows only to determine the percentage of bone loss, but also to identify structural disorders of the bone architectonics.

Mechanism of development of bone tissue pathology

Bone is a highly specific tissue, which contains three structural elements:

• protein matrix, which is the main connective tissue that retains mineral substances in the bone;
• a mineral component consisting of calcium and phosphorus;
• bone cells responsible for bone tissue reconstruction.

Contrary to the prevailing opinion, the bone does not have a permanent, once-formed structure.

In fact, it is a living structure, the main purpose of which is to ensure the optimal maintenance of the human body.

During life, the nature of the loads on the supporting apparatus of the human body is repeatedly changed, the reasons for the changes can be:

• increase in body weight;
• change in lifestyle (increase or decrease in mobility);
• increase in external loads (systematic lifting of weights), etc.

The influence of these factors causes the bone to constantly perform internal rearrangement, which allows to maintain stability and to counteract as much as possible changing loads.

In this case, the bone tissue is destroyed in a place that does not require increased strength, and the formation of a harder, in the most "loaded" area.

Regular physical loads stimulate metabolic processes in the bone structure

The age period up to 20-30 years is characterized by a high rate of metabolic processes in which, under the influence of various factors (power loads, the amount of calcium consumed, hormonal changes), formation bones. After reaching the maximum mass of bone tissue, the loss and recovery processes are balanced. The main cause of osteoporosis is the predominance of processes of resorption (destruction) over the formation processes.

Important! If in young people the rate of metabolic processes in the bones is 50% within a year, then the age categories older than 50 years, not more than 5%, while the processes of resorption inevitably prevail over the processes formation.

Indications

Since the loss of bone mineral density (BMD) is always a consequence of some disease or condition, there are certain categories of individuals who are osteoporosis.

Thus, indications for examination are:

• age over 45 for women and over 55 for men;
• women in the postmenopausal period;
• endocrine disorders (diabetes mellitus, thyroid dysfunction);
• multiple pregnancies (more than 3) or prolonged breastfeeding;
• several cases of fracture of bones within 3-5 years;
• patients taking the drugs of the group of corticosteroids, as well as tranquilizers and anticonvulsants;
• keeping a sedentary lifestyle (prolonged bed rest, use of a wheelchair);
• sharp weight loss or a constant low weight;
• the presence of relatives with a diagnosis of osteoporosis.

Important! Insufficient intake of vitamin D in the body can cause osteoporosis. Smoking and drinking is one of the reasons for the development of osteoporosis.

Diagnostics

Among the list of tests for osteoporosis, densitometry rightfully takes the leading place, as it allows to make a quantitative assessment of bone tissue.

Certain information useful for assessing the intensity of bone destruction, has a urine test for the amount of calcium released and hydroxyproline, which in patients with progressive osteoporosis is usually more excreted in the urine rather than absorbed organism.

In addition, the initial examination includes a urine test for deoxypyridonoline (DPID), excreted in urine in an unchanged form (unbound) as a result of slowing or absence of metabolic processes in bone tissue.

Since the main purpose of diagnosing osteoporosis is to identify a category of patients prone to a decrease in bone mass, it is advisable perform a comprehensive assessment of osteoblast activity, determined by the number of osteocalcin per day, parathyroid hormone, alkaline phosphatase and deoxypyridonoline.

Table. Normal indicators of biochemical markers

Indicators	Unit. amendment	Norm
men	women
Calcium total	mmol / l	, 5	, 5
Phosphorus	**	, 0	, 0
Parathyroid hormone	pmol / l	,	,
Deoxypyridonoline	DPID / mole	,	,
Osteocalcin	ng / ml	15,	, -5,

A fairly high diagnostic value is the detection of the concentration of female and male sex hormones, since it is the endocrine disorders that often cause the development of osteoporosis.

X-ray densitometry

Densitometry is the most commonly used method of examining bones for osteoporosis.

The term "densitometry" combines several methods of obtaining an image, allowing to perform a quantitative assessment of bone mineral density (BMD), the patient being examined.

Certain results in the evaluation of the MIC were achieved using a conventional X-ray.

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However, it is not possible to obtain any meaningful quantitative result with its help.

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The determining factor that excluded radiography from the lists of methods used to diagnose osteoporosis was the one the fact that even when evaluating a picture by an experienced physician, it was not possible to reveal a loss of bone tissue of less than 40% possible.

Conducting a dynamic assessment of the progression or regression of the disease is also rather difficult, due to the low sensitivity of the equipment.

Important! It is advisable to study the degree of changes in the BMD in the parts of the skeleton where the proportion of trabecular tissue predominates (neck of the hip, lumbar spine, wrist joint), as osteopenic changes affect it in the first queue.
It is impossible to diagnose insignificant loss of bone tissue with an X-ray

The most popular methods of X-ray examination of the IPC are:

• dual-energy x-ray absorptiometry (DEHA);
• morphometric X-ray absorptiometry (MRA);
• quantitative computed tomography (CT).

All X-ray methods for studying the degree of reduction of BMD are based on the movement of ionizing radiation from a source located outside, through the bone to the fixing detector.

In this case, a narrow beam of X-ray radiation is sent to the object under study and the final result, that is, the intensity of radiation transmitted through the bone is fixed by the computer system.

How often can X-rays be taken?

The main principle of the DEHA method is the use of double radiation, which allows maximum reduce the error due to registration of two energy absorption options (in soft tissues and bones).

The MRA method is a variant of DEHA, however, the use of a fan radiation flux image quality and reduce the scanning time, and accordingly reduce the radiation dose of the patient.

The CCT method allows to obtain a three-dimensional image and not only to determine the BMD, but also to obtain data on the layered structure of the bones, that is, to assess the condition of the trabecular and cortical layer.

The negative side of the use of CCT is a high dose of radiation, exceeding DEHA by 10 times and the dependence of the accuracy of indications on the number of bone marrow, the percentage of which with age increases.

Ultrasonic computer densitometry

The ultrasonic densitometry method is based on the calculation of the velocity of the ultrasonic wave traveling through tissues having different densities.

The difference in the density of the examined bone causes differences in the speed of passage of ultrasound, then there is a denser bone (well mineralized) lets the ultrasound pass faster than the less dense.

The received data are registered by the sensor and converted by computer support into quantitative indicators.

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A characteristic property of ultrasonic densitometry is an extremely high sensitivity to the slightest changes in bone density.

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In this regard, it can be used to diagnose osteopenia, when the loss of mineral substances does not exceed 3-5%.

Undoubted advantages of ultrasonic computer densitometry methods can be considered:

• sufficiently high information content;
• absence of negative influence on the body;
• the speed of the procedure;
• price accessibility;
• absence of contraindications.

Due to such a large list of positive sides, ultrasonic densitometry can not be used only for the diagnosis of osteopenia and osteoporosis, but also for monitoring the effectiveness of the therapy.

In connection with significant deviations, manifested when examining bones deeply embedded in soft tissue (proximal section femoral bone), densitometry with ultrasound is performed exclusively on the limbs (wrist, heel and etc.).

The most informative for carrying out ultrasonic densitometry are the tubular bones

Conducting and delivering results

The technique of X-ray densitometry consists in performing a complex of measurements with the help of X-ray diffraction patterns at several standard points most susceptible to osteopenic changes:

• lumbar spine;
• the neck of the thigh;
• radius.

After executing a series of images, the software performs the processing of the results obtained by comparing it with the database that was put into it. The comparison is carried out by two criteria:

• the result obtained with the optimal index of patients of the same sex (T-test);
• the result obtained with the average statistical index of patients of similar sex and age (Z-test).

The most informative in the diagnosis is the T-test, checking the degree of its deviation from normal indices, has a significant diagnostic value:

• the readings above 1" indicate a normal IPC;
• indications ranging from 1" to indicate osteopenia (the initial stage of osteoporosis);
• the indications below speak about the development of osteoporosis.

The ultrasonic densitometry is carried out by determining the density of the cortical (outer) layer of tubular bones.

To do this, using ultrasound transducers, the ultrasonic wave is passed along the bone, determining by the speed of its propagation of the MIC.

Within a short period of time, the device performs thousands of measurements and, based on the results, calculates the Z and T-criteria. Standard projections for carrying out ultrasonic computer densitometry are:

• phalanx of the middle finger;
• ray or wrist.

Important! The results obtained with the help of X-ray and ultrasonic methods may have some differences, but the final values ​​are usually treated equally (norm or osteoporosis).
Structural changes in bones: left - normal, right - osteoporosis

In connection with the individual characteristics of the course of the disease, obvious signs of bone tissue destruction, such as fractures, may not be. However, timely diagnosis, can significantly reduce the risk of such a serious complication, such as a fracture of the neck of the hip.

Despite the fact that pathology is not fatal, long-term reduction in motor activity and expensive treatment (prosthetics), which is also impossible to perform in severe stages of osteoporosis, often lead to lethal outcome.

To date, in the arsenal of doctors there is a large number of medicines intended for treatment osteoporosis, but due to the fact that the recovery process is extremely long, it is optimal to start it as much as possible before.

A source: http://diametod.ru/prochee/densitometriya-diagnostika-osteoporoza

Densitometry - examination for osteoporosis

Densitometry is a medical study that can diagnose osteoporosis at an early stage. Instruments using which this procedure is performed are called densitometers. The main task of diagnostics is to determine the mineral density of bones in certain parts of the skeleton.

Depending on the tasks, the central and peripheral densitometry is distinguished.

The area of ​​the study of central densitometry is the lumbar spine and the proximal femur.

With peripheral densitometry, the forearm, the calcaneus and the phalanges of the wrist are examined for the diagnosis of osteoporosis.

Densitometry is the main method of diagnosing osteoporosis. The principle of operation is based on the fact that the X-ray tube emits a beam consisting of two components.

This radiation is absorbed in different ways by normal and demineralized bone tissue.

The accuracy of bone mineral density (BMD) is from 0.5 to 1%. In addition to the obtained indicators, modern devices reproduce high-precision images on which demineralization zones are indicated.

Evaluation of densitometry

Evaluation of the diagnosis of densitometry is performed according to two indicators, which speak of the degree of development of osteoporosis in the bone:

• The T-test is compared with the mean values ​​in the patients of the control group of 30 years of age. Accordingly, the T-score can be positive and negative.
• The Z-test is compared with the mean values ​​of the same age in the control group. Again, the values ​​can be positive and negative.

The result is given in percentages and expressed in the SD coefficient.

For different groups of patients, divided by sex, age and ethnic group, normative bases of normal indicators were created.

However, the conclusion should be evaluated by a qualified specialist who takes into account also the severity of the clinical picture, the alleged etiologic factor of the development of the disease.

Conduction of densitometry

Examination for osteoporosis - densitometry - should be carried out by specially trained personnel of the radiology department.

The dosage of irradiation for this study is minimal, therefore, according to the instructions, the densitometer does not need a special room.

However, in practice, the equipment must still be installed in the radiology department, which has its own requirements.

The patient is placed on his back and throughout the examination he must lie still. In advance of the examination for osteoporosis, the patient is asked to remove all radiopaque subjects, since densitometry is an X-ray examination.

The procedure is absolutely safe for the patient, the radiation dose is minimal. The study itself, depending on the selected zone, takes 15 to 20 minutes, is not invasive, without anesthesia, painlessly.

Densitometry determines osteoporosis at the demineralization stage, starting at 3%, in contrast to the same analysis for simple radiography - it is effective in the loss of bone mass, starting at 25%.

Indications for densitometry

Analysis for osteoporosis - densitometry, like any other study, has definite indications. According to the recommendations of the International Society for Clinical Densitometry, this examination is necessary:

• Annually to women after age 65;
• Every year, men after 70 years;
• At any age, patients who fall into the following risk categories:
  • Have bad habits: smoking, alcohol abuse;
  • Have a low body weight;
  • With obesity;
  • Have a history of frequent fractures;
  • Taking hormone therapy;
  • Have endocrine diseases;
  • With rheumatism.

Also with the help of densitometry, compression fractures can be diagnosed and their degree evaluated. In this case, there are indications for the procedure:

• If there is a suspicion of a fracture of the spine;
• With a decrease in the growth of an adult person by more than 2 cm;
• With frequent fractures in the anamnesis;
• Patients taking glucocorticosteroids.

Densitometry in the "Open Clinic"

Densitometry, as a diagnosis of early osteoporosis, is a fairly popular procedure in Moscow, and its price varies from 700 rubles to several thousand in various clinics. Such a wide range of prices is associated with the qualities, sensitivity and capabilities of the device itself, the qualification of a specialist, the field of research.

In the "Open Clinic the diagnosis of osteoporosis is densitometry at a price of , 00 rubles. The study time is about 20 minutes.

In our clinic we use modern densitometric equipment, which allows us to carry out early diagnosis of osteoporosis, assess the state of bone mineral density, the state of the cortical layer bones.

Types of densitometry:

• X-ray
• Ultrasound

Entry to the Kuntsevo Center: +7 (495) 419-98-78
Entry to the Presnensky Center: +7 (495) 255-36-36

A source: https://www.dikul.org/diagnostycs/densitometriya/diagnostika-osteoporoza/

Diagnosis of osteoporosis by bone densitometry

Bone densitometry is a method of determining the concentration of minerals in the bones.Densitometry can detect osteoporosis and determine its degree for proper treatment.

Modern medicine is ready to offer 2 main ways of conducting diagnostics: X-ray densitometry and ultrasonic. There are also photon absorptiometry, which, like the main ones, is accompanied by painful interference.

Types of bone densitometry

X-ray densitometry is the use of an X-ray machine to determine the diagnosis if the loss of bone mass is 20-25%.

This technique is the most informative and therefore is used when osteoporosis reaches serious stages of development.

Densitometry of this kind is divided into several types:

Two-energy densitometry. It is based on measuring the absorption of the x-ray ray beam. The higher the bone density, the more difficult it is for the ray to pass through it.

Two different rays are used for the vertebrae and femur.

Densitometry of the x-ray type has fairly accurate indices, which are achieved by comparing the results of ray absorption with soft tissues and bone.

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Photon absorptiometry. The density of bones in such a diagnosis is determined by measuring the absorption of bone by radioisotopes.

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Doses of radiation are rather insignificant.

Such diagnostics can reveal the level of mineralization of the bones of the legs and hands, but can not assess the condition of the spine and femur.

Ultrasonic densitometry (ultrasound). This study is the safest, however, the accuracy of its results is not high enough compared to previous methods.

Bone density by ultrasound is determined by the reflection of the ultrasonic wave from the bone site and its dispersion in the thickness. US-procedure shows the level of bone elasticity, stiffness and density.

Ultrasound of the bones can determine not only fractures, but also incorrect fusion of bones, degenerative and erosive destruction of the bone surface (for example, with tolerated osteomyelitis).

Application

Bone densitometry is used in the following cases:

• during menopause, in particular, if it occurred before 50 years;
• if glucocorticoids (prednisolone) were taken, with vasculitis, systemic lupus erythematosus and other rheumatic diseases;
• for people over 30 years (especially women) who have at least once experienced osteoporosis in the family;
• low growth and leanness predispose to the appearance of osteoporosis;
• with alcohol abuse;
• if there is a sedentary lifestyle;
• in the case of an operation to remove the ovaries;
• after any bone damage.

Contraindications

Ultrasound does not have any contraindications. Ultrasound can be performed at any age and in any condition. Ultrasonic densitometry of the lumbar spine has no negative effects and is not subject to additional examination.

This can not be said about radioisotope and X-ray diagnostics.

Also worth noting that they are difficult to implement in the supine position on the back and on a hard surface, because patients with diseases of the lumbosacral spine and both, and other studies it is contraindicated.

Preparation for research

Preparation for the survey does not require a certain diet or a complete hunger strike. However, there are several rules that require a procedure for the accuracy of the results:

3-4 days before a study is to be carried out, all food additives that contain calcium and phosphorus, there should also be no foods rich in calcium (cheese, cottage cheese and etc.).

If the day before the procedure was carried out a survey using a substance of barium (X-ray contrast medium), then this should be reported to the doctor.

In the presence of the slightest suspicion of pregnancy, only ultrasound should be used.

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Preparation requires free clothing without metal elements and ornaments (in particular, it is important in the combined procedure with the use of MRI).

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Densitometry of bones provides, as a rule, prices within 2 thousand Russian rubles. Nevertheless, the price breakdown is quite large.

Depends, of course, on the level of the clinic, the state of medical equipment, the type of study (ultrasound much cheaper X-ray examination), the area of ​​the body for study and the city (for example, in the capital is more expensive than in regions).

The cheapest densitometry is diagnosis of the spine, hand and forearm (from 900 Russian rubles to 2-3 thousand). A full study of the skeleton will cost much more - depending on the clinic, from 2, 5 thousand to 6.

Conducting research

Densitometry of the X-ray type is performed using X-ray densitometers equipped with special sensors. It is these sensors that determine the radial intensity that passes through the body. The results will show whether the patient has osteoporosis.

How is densitometry done? Bone densitometry is fast and painless. By time it takes, usually from 10 minutes to 1 hour.

The patient lies on a special table, at the bottom of which there is an X-ray source. Above the patient is a detector that measures the patency of the rays.

The patient must remain still to get a clear image.

Explanation of results

Density of bones and, respectively, osteoporosis are determined on the basis of two criteria. These criteria are called the T-test and the Z-criterion. Decoding with the help of these criteria is established and recommended by the World Health Organization.

The T-test compares the condition and bone density of patients with an ideal index (young people 30-35 years of age). The norm for the indicator is a value of 1 point.

If the value varies within the limits from -1 to -2, 5, then "osteopenia" is diagnosed - this is a reduced density of bone tissues.

If the indicator falls below -2, 5, then the diagnosis is osteoporosis.

A source: http://drpozvonkov.ru/diagnostika/densitometriya/densitometriya-kostey.html

Densitometry in osteoporosis: indications, conduct, results

Osteoporosis is a systemic disease characterized by a metabolic disorder in the bone tissue. First of all, the bones lose an important macroelement - calcium, responsible for their hardness and strength.

The loss of the leading link from the exchange cycle leads to serious complications on the part of all organs and systems.

Therefore, densitometry in osteoporosis serves as an important diagnostic method, which makes it possible to detect a disease "at the crime scene".

Often, patients do not suspect the existence of an insidious pathology, referring at the same time for qualified trauma care to exclude a fracture.

Meanwhile, osteoporosis slowly but surely weakens the defense of bones and makes them vulnerable (fragile) to external environmental factors.

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Sometimes it is enough for a person to get a minor injury (bruise), which in fact can be a serious problem (cracks or fractures).

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Therefore, it is important to detect the disease at an early stage of development, so as not to miss the precious time. According to the results of densitometry, the degree of osteoporosis is indicated by the display of digital values ​​on the screen. And this means that the outcome of the disease directly depends on the neglect of the pathological process.

As you know, science does not stand still, therefore, medicine develops at a rapid pace. To help specialists of different profiles invented a "miracle" - an instrument (densitometer) that determines quickly and accurately even minor deviations from the norm of calcium values ​​in bone structures.

Densitometry against osteoporosis

Scanning for densitometry

The uniqueness of the method is that it is not necessary to perform surgical manipulations to determine the level of calcium in the bone tissue.

Thus, the subject does not experience any additional inconvenience during the medical procedure, except for touching the sensor in the field of examination.

The designated area serves as an object for studying the amount of calcium, depending on the sex of the patient and his age.

The miracle of technology allows us to catch the first signs of osteoporosis by surprise, which is very important for a favorable outcome of a possible disease.

It is better to prevent the disease than to face the serious complications (frequent bones fractures with and without bias).

Who needs a survey?

The following categories of citizens fall into the risk group:

• The representatives of the fair sex in the critical period before and after menopause;
• men after the age of 60;
• men and women after 40 years due to a fracture, in the absence of injury;
• representatives of both sexes with growth below 150 cm, not having a genetic predisposition to stunting;
• patients with an endocrine pathology in the anamnesis.

It is important to note that all patients are recommended to undergo densitometry in the presence of osteochondrosis, deformations of the spine (lordosis, scoliosis, kyphosis), protrusions (protrusion of discs) and intervertebral hernia.

In addition, a long course of hormone treatment involves examining bones for osteoporosis. If the patient was treated for an identified calcium deficiency in the bones, then a checkup should be performed to monitor the effectiveness of the therapy.

Bone densitometry (DEXA)

The examination is also called dual-energy X-ray absorptiometry or (DEXA) scanning. DEXA scanning is an established standard for measuring bone mineral density (BMD).

This is a simple, rapid and non-invasive medical test that involves exposure to individual parts of the body a very small amount of ionizing radiation and is used to obtain images of entrails body.

DEXA scanning is usually performed on the lower part of the spine and thighs.

Scanner Features

The scanner itself differs in that it produces two X-ray beams, each beam with different energy levels. One beam of high energy, while the other - of low energy.

The amount of energy that can pass through the bone is measured separately for each ray, and depends on the thickness of the bone.

By the difference in the results relative to the amount of energy that can pass through the bone, between the two beams, the density of bone tissue is calculated.

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The density is directly related to the calcium content of the bone. Therefore, thick bones contain more calcium than thin bones.

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Conventional X-ray scanners can not accurately measure the calcium content in bone tissue, and therefore a patient with osteoporosis can have perfectly normal radiographs.

How to scan

Information that is usually of interest to patients:

1. The examination is carried out on an outpatient basis. The patient comes to the hospital and, after the examination, goes home the same day.
2. Scanning takes 10 to 30 minutes, depending on the equipment used and the area of ​​research.
3. It is very important that the patient remains immobile during the procedure, and may also be asked to hold his breath for several seconds while the image is projected.
4. Patients can eat just before the test and remain fully dressed if the clothing does not have metal buttons or buckles.

If the doctor checks the presence of osteoporosis of the lumbar spine and hip, as a rule, Forearm is also considered, as this will give an idea of ​​the difference in the calcium content in the parts of the body.

Recently, portable scanners have become popular, which can be used even in the office of a general practitioner and check the mineral density of the calcaneus or phalanges of the fingers.

results

After the DEXA scan has been performed, the radiologist (the doctor who supervises the survey process and interprets the image) issues the result of the survey.

The results will be in the form of 2 points or criteria, the T-test and the Z-test.

T-test: this comparison of bone mass with a young man of the same sex with a peak density of bone mass.

Any estimate of up to -1 is considered the norm. The result of -1 to - is considered a reduced bone density and is classified as osteopenia. Below is classified as osteoporosis.

The T-test provides an indication of the risk of fractures and the need to start treatment, and is accepted by WHO for assessing bone tissue and is used by practitioners.

Z-test: reflects the amount of bone mass compared to other people, within the same age group, the same weight and sex.

Why do different bones

The density of bone tissue as a whole is determined by the density of two quite different layers or substances, of which it consists: trabecular and cortical.

The defeat of each type of bone tissue depends on the causes that caused osteoporosis.

For example, with postmenopausal osteoporosis, prolonged hormone therapy, the trabecular substance is more likely to suffer.

Cortical bone material suffers with senile, diabetic osteoporosis, or with dysfunction of the thyroid and parathyroid glands.

Approximate ratio of trabecular and cortical substance in different bones of the skeleton:

The site of the skeleton	Trabecular substance	Cortical substance
Middle third of long tubular bones	5%	95%
Distal third of long tubular bones	25%	75%
Femoral neck	25%	75%
Large spit of the femur	50%	50%
Lumbar vertebrae	66%	34%
Thoracic vertebrae	75%	25%
Ultradistal part of forearm bones	75%	25%
Heel bone	90%	10%

A great informativity in the survey can be obtained by determining the mineral density of different bones (one element with predominance of trabecular substance, and another - a cortical substance), and also to draw conclusions about the causes of osteoporosis in a particular patient (depending on which bones are detected process).

about densitometry from Elena Malysheva's transmission:

Quite often, patients ask themselves - what densitometry best identifies osteoporosis? Of course, all modern techniques for detecting problems with calcium metabolism in bone structures are effective.

But experts still prefer in screening - ultrasonic densitometry of osteoporosis, as the safest method of examination.

In addition, it is important for patients to know how often densitometry can be done in osteoporosis. Only the attending doctor is ready to answer this question, because the diagnosis of osteoporosis with dysmetry is carried out in each individual case according to an individual scheme.

It is important to take into account that calcium in the human body is necessary not only for proper growth and development of bone tissue. The health of internal organs and systems directly depends on the optimal level of this macroelement.

Muscular tissue reacts badly to calcium deficiency. The heart muscle is especially sensitive to metabolic disorders. The main motor of the human body must work without interruption, so it is vitally necessary for calcium.

A source: http://spinaisustav.ru/densitometria-pri-osteoporoze/

Densitometry

Densitometry is a non-invasive diagnostic technique that allows to determine the exact density of bones or their mineral mass.

If there is a suspicion of osteoporosis, densitometry is the leading method of diagnosis (the "gold standard"), authentically allowing to confirm the presence of disorders, and also to reveal the degree of progression disease.

Densitometry is the main method of diagnosing osteoporosis

This examination detects even a small loss of bone mass and is able to detect abnormalities stage, when osteopenia was not transformed into osteoporosis and there is a chance to designate an effective and timely treatment.

Types of research

There are several main types of this study:

• Ultrasonic densitometry is one of the safest, non-radial, modern methods that allows you to determine the density of bone tissue.
• X-ray densitometry is the most accurate method for quantifying the mineral mass of bone tissue.
• Photon absorptiometry is a technique based on the evaluation of the absorption of the radioisotope by the bones. In a monochrome technique, the density of peripheral bone tissue is measured. In the case of a dichromate, the degree of loosening of both the peripheral bones and the spine, as well as the femur, is determined.

X-ray densitometry is used to determine the mineral density of bones

There may be minor differences in results if the examination was conducted in different clinics using different models of apparatus.

Conducting ultrasonic densitometry

Ultrasonic densitometry is a modern, effective research method that allows us to identify even minimal loss of density (from 3 to 5%): the higher it is, the lower the resistance of bones to violations integrity. Conventional X-ray studies can detect the disease only if there is a significant violation of mineralization.

Ultrasonic densitometry can detect even minor bone density disorders

During the procedure, the doctor also evaluates such indicators as stiffness and elasticity of bone tissue. The method is based on the degree of reflection of ultrasonic waves from the surface of bones. The advantages of this type of research are:

• Absence of radiation exposure.
• Short duration of the study.
• Material accessibility.
• Absence of pain.
• It can be used repeatedly during the examination of pregnant women.

Using the ultrasound diagnostic method, you can measure the density of bone tissue in the area of ​​the finger or heels.

In some cases, this may not be sufficiently informative, which allows only preliminary conclusions to be drawn.

In the study of the femur and the spine, the x-ray type of examination is more informative.

The ultrasound method is the most informative in the examination of the bones of the wrist

X-ray densitometry

This X-ray method consists in measuring the amount of absorbed rays by bone substances.

With densitometry, the X-ray and its radiation power are hundreds of times smaller than with a standard X-ray study.

Through the X-ray, the following areas of the body can be examined:

• Densitometry of the spine.
• Densitometry of the lumbar region.
• Densitometry of the femoral neck, especially of the upper part.

With x-ray densitometry, the degree of irradiation of the patient is lower than with conventional x-rays

Of particular value are the results of examination of bone mineral density of the cervical spine and femur. It is these bone elements that are characterized by their reduced density and require special attention.

Indications

The main indication according to which densitometry of bones is performed is the presence of diseases and conditions, accompanied by a decrease in bone mineral density. Therefore, the densitometric method of investigation is used in the following cases:

• Control of the use of medicines on the basis of calcium, complex medicamentous therapy of osteoporosis.
• Parathyroid dysfunction.
• Age of more than 40 years for women and more than 55-60 years for men.

Densitometry is used to detect and monitor the treatment of osteoporosis

• Use of drugs that help reduce bone mineral density: corticosteroids, psychotropic substances, oral contraceptives, agents with a diuretic, anticoagulant and anticonvulsant action.
• Early menopause, including, caused by surgical intervention.
• Presence in the anamnesis of the fracture provoked by the minimal trauma.
• Birth of 3 or more children, prolonged period of breastfeeding (more than 8 months).

Often, osteoporosis is considered a disease that affects older age groups. However, bone densitometry is indicated for all categories of patients over 30 who are at risk:

• With a hereditary predisposition to the development of osteoporosis.

The tendency to develop osteoporosis is in patients with hypodynamia

• Hypodynamics.
• With prolonged stay in a state of weightlessness.
• Low body weight (less than 55 kg).
• Dysfunction of the hormonal system, accompanied by a decrease in the amount of estrogens and other hormones.
• In the absence of a varied balanced diet, inadequate quantities of dairy products, bananas, vegetable oils, foods rich in calcium and vitamin D3 in the diet.
• When consuming a large amount of caffeine-containing beverages, exposure to unloading days and medical starvation.
• When drinking alcohol and smoking.

The abuse of caffeinated drinks causes a violation of bone mineral density

• With non-observance of the regime of work and rest, considerable psycho-emotional overstrain.
• Presence in the anamnesis of diseases which can provoke an osteoporosis.

Densitometry of the spine should be performed regularly if at least one or a combination of risk factors is present.

Contraindications

The ultrasound method of research is highly safe, so it has no contraindications.

It is recommended to abstain from radiographic examination for pregnant and lactating women.

Among the relative contraindications, the presence of an inflammatory process in the region lumbosacral spine, because in this case it is difficult for the patient to take necessary position.

During the period of breastfeeding, the procedure is contraindicated

Training Rules

To make densitometry it is possible in modern diagnostic clinics: both private and public. There are no specific preparatory measures for the study, but attention should be paid to the following recommendations:

• If you perform a primary diagnosis of osteoporosis, then do not take drugs, calcium content, and use other means that can increase the content of this trace element in the blood.
• On the day of the study it is recommended to give preference to comfortable clothes, zippers and metal elements (buttons, rivets) should be absent.

On the eve of the examination, it is necessary to limit the intake of calcium preparations

• Jewelry from metal will need to be removed.

If a woman is in the situation at the time of the examination, this must be reported to the attending physician.

How is the procedure performed

It is important to know how densitometry is carried out in order to be mentally prepared for the survey. This procedure is characterized by the absence of pain or any other unpleasant sensations, the use of anesthetics is not required. The process depends on the type of study:

• Ultrasonic densitometry is performed using portable densitometers, which fix the rate of ultrasonic wave arrival to the bones. A special sensor captures all the indicators and displays them on the monitor screen. For several minutes, the device will determine how fast the ultrasonic waves pass to the area of ​​the bone structures. During the survey, preference is given to both "dry" and "wet" devices. In the first case, a small amount of a special gel is applied to the area under investigation, in the second case, the limb or body is completely immersed in a container filled with water.

For diagnosis by ultrasound, portable densitometers are used

• During the X-ray densitometry, stationary equipment is used. The patient will be offered to remove shoes and outer clothing, to occupy a horizontal position on a specially equipped soft table, under which the x-ray is located. The device that processes the resulting image will be located above the patient. During the survey it is necessary to maintain immobility in order to obtain the most accurate picture. If a densitometry of the spine is prescribed, the cervical section is most often subjected to a thorough examination. During the procedure, the scanning console slowly passes over the patient.

Evaluation of results

The task of the densitometer operator is to record the obtained data and give the patient pictures with the conclusion.

The results of densitometry are determined by taking into account several key criteria: Z and T.

The deciphering process is performed by the attending physician, after which he appoints the appropriate treatment regimen if necessary:

• By means of the Z-criterion determine and compare the results with the average rate of the norm among people of the same age group.

Evaluation of the results of densitometry is performed by the attending physician

• When studying the T-test, the results are compared with normal indicators of bone tissue density in healthy women from 30 years of age.
• To determine the bone density, one unit SD is used.

If exceedances or decreases in the Z-test are detected, additional research methods may be recommended.

To whom is shown the ultrasound of bones

Unlike densitometry, bone ultrasound is used to assess the condition of the surface of bone tissue and cortical layers.

A similar kind of diagnostics is used for injuries, infectious lesions, rheumatoid arthritis.

It allows to reveal not only a fracture, but also a violation of the process of bone adhesion, the presence of ulcerative formations and degenerative-inflammatory changes.

Ultrasound of bones is used to identify fractures after a trauma

This method of diagnosis is often used to identify fractures in children, so as not to expose the children's body to x-ray irradiation. Ultrasound can detect not only fractures, but also inflammatory processes in surrounding soft tissues.

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For the appointment of a suitable method of research, it is recommended to consult a qualified rheumatologist or orthopedist. The earlier the existing disorders were identified and the correct treatment scheme was chosen, the more favorable the prognosis for the patient.

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What is densitometry and in what cases is it conducted, will acquaint the video:

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