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Diagnostcis

Diagnostic of osteoporosis

Dijagnostika osteoporoze - uz tekst

Bone density measurement

Osteoporosis is a chronic, progressive bone diseases which leads to development of a fragile bone with an increased susceptibility to fracture.

First signs of osteoporosis are decrease in height, spine deformity, kyphosis, while the onset of sudden, strong back pain is usually a sign of a vertebral fracture. Fracture may occur spontaneously or due to the sudden, irregular movement, after fall, after lifting weight in bend position. Vertebral fractures are often unrecognized and diagnosed only later, on the X-ray.

However, in order for osteoporosis to be visible on X-ray (thoracic and lumbar spine), the bone loss must be over 30%.

Specialist examination

Patients can come for consultations, either through a referral or themselves if they want to find out about their bone density and risk for osteoporosis. The specialist examination includes a thorough history, the questionnaire for fracture risk and clinical examination.

Patients are then referred to the osteodensitometry – bone density measurement – DXA.

DXA osteodensitometry

Bone density measurement – DXA osteodensitometry is a golden standard for an early diagnosis of osteoporosis. Bone density is measured in the areas of lumbar spine, hip and lower arm. The method is reliable, precise, painless, comfortable and lasts for a few minutes, with minimal radiation dose.

Beside the bone density, the DXA Lunar Prodigy Advance apparatus in the Institute has the body composition measurement, pediatric and orthopedic software (measuring the BMD around the

artificial joints implant).

X-ray diagnostic of the spine should be done in the following situations:

  • suspected osteoporotic fracture
  • sudden, strong back pain
  • loss in height more than 3 cm
  • normal DXA finding but clinically suspected osteoporosis

Clinic for osteoporosis has a multidisciplinary team – rehabilitation specialist, specialist of medical biochemistry, nurses, physiotherapists, occupational therapists, psychologist, X-ray technicians,

lab. technicians. When needed, the team is enhanced with endocrinologist, orthopedic surgeon, gynecologist and social worker.

Lab. analyses are necessary in order to exclude the secondary causes of osteoporosis: In Laboratory the following analyses are available: sedimentation rate, blood picture, creatinine, alkali phosphatase, calcium and phosphorus in serum and 24-hours urine, liver test (AST, ALT), protein electrophoresis, vitamin D (25-OH) in serum, markers of bone metabolism. Markers of bone metabolism are helpful for evaluation of the bone destruction process, therapeutic response and risk for fall.

 

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