How to diagnose osteoporosis?

Currently, there is a way to diagnose osteoporosis once established through bone densitometry.

Osteoporosis is a progressive disease of the skeleton, characterized by a decrease in bone strength that facilitates the development of fractures. It is the second healthcare problem in the world after cardiovascular diseases, according to the World Health Organization (WHO). Its prevalence is increasing given the progressive ageing of the population.

 

During ageing, the loss of bone mass continues, both at the level of the spine and the hip, which has begun in postmenopause in women, and around 60 years in men. In old age, it is also when the great majority of fractures due to bone fragility occur, whose incidence increases exponentially in those over 75 years old.

 

Related article: What are the symptoms of osteoporosis?

 

 

Diagnosis

 

Our doctors at the London Spine Unit examine our patients carefully. We follow the next steps:

-Interrogatory: To find out all the details of the onset of signs and symptoms.

-Physical examination.

-Complementary examinations: In order to identify possible underlying processes that determine secondary forms of the disease.

 

Specialists can make the diagnosis of osteoporosis in the presence of a fragility fracture (low-intensity trauma). However, it is very important to diagnose the disease before this complication appears.

 

Bone mineral density

It is the measurement of the amount of minerals (usually calcium and phosphorus) that a certain volume of bone contains.

Therefore, at present, the term osteoporosis is used more and more to describe cases of bone mineral density (BMD) decline before any fracture has occurred. So we call severe or established osteoporosis to cases where fractures have happened.

The asymptomatic condition of osteoporosis then makes the diagnosis depend on, on the one hand, the individual estimation of fracture risk and, on the other, much more objective, on methods that quantify bone mass and assess bone quality. The estimation of the risk of fracture complicates by the number of involved factors in the causes of the disease, this along with the lack of techniques that measure the quality of bone, means that at present doctors base the diagnosis of osteoporosis mainly on the assessment of BMD.

 

Densitometry

 

The only bone measurement technique currently recognized and validated by WHO is double-beam densitometry. The densitometric criteria established by the WHO establish the diagnosis of osteoporosis according to the value of the T-score. It takes as reference the peak of bone mass or maximum population value, which is the average of the young adult.

 

When should you get densitometry?

There are specific groups of people in which densitometry seems to be a beneficial test to assess the bone loss, fracture risk or response to medical treatment. Some of them are:

-Postmenopausal women with severe symptoms, no hormonal treatment and low estrogen consumption.
-Also, postmenopausal women who smoke or have smoked throughout their lives. Tobacco accelerates the loss of calcium in the bones.
-Men and women with diseases that associate to bone loss (multiple myeloma, type 1 diabetes, kidney or liver disease…).
-Elderly people who have a history in their family of hip or spine fracture.
-People who consume medications that cause loss of calcium in the bone (corticosteroids, antiepileptics, alcohol, etc.).
-Anyone with hyperparathyroidism, a disease where the parathyroid hormone is very high. It causes the bones to release the calcium they have into the blood.
-People who have had a fracture in any part of the body after a not very strong blow. This makes us suspect that they have too fragile bones.

 

At the London Spine Unit, we have some of the best specialists to diagnose and treat your osteoporosis. Book a consultation to get a checkup.

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