Osteoporosis is one of the most common serious diseases. It is accompanied by a decrease in bone mineral density. According to this invariable feature, it is possible to diagnose osteoporosis. In particular, densitometry will help in this. What is this study? What kind of patients is it indicated for? How is densitometry performed? How to decipher the results of this diagnostic procedure? We will answer these and other important questions below.
Definition
What is densitometry and how is it performed? It is a non-invasive diagnostic method. Its main purpose is to determine the concentration of calcium in bone mass. For this purpose, areas of the skeleton subject to pathological changes are usually examined. Most often it is the spine and femoral neck. After all, injuries, and even more so fractures of these areas, are fraught with a complete loss of motor functions for a long period of time.
We continue to get acquainted with densitometry. What it is? How is it carried out? Under this name unitesseveral procedures, each of which has specific features:
- Ultrasonic.
- Quantitative computer.
- Quantitative magnetic resonance.
- Dual energy x-ray.
We will present the methods in detail below.
Indications for examination
Densitometry according to CHI is provided to a number of patients whose diseases require periodic repetition of this diagnosis. Experts recommend contacting densitometry for prevention purposes at least 2 times a year for the following categories of people:
- Women during menopause (especially with early onset of menopause).
- Persons diagnosed with at least one bone fracture due to minor trauma.
- Women who have had their ovaries removed.
- Persons suffering from parathyroid disease.
- People over 30 years of age whose close relatives have suffered from osteoporosis.
- Persons who have been treated for a long time with drugs that help leach calcium from bone mass. These are anticoagulants, diuretics, glucocorticosteroids, psychotropic drugs, tranquilizers, hormonal oral contraceptives, anticonvulsants.
- People of short stature with low body weight.
- Women over 40 and men over 60.
- Alcohol and tobacco abusers
- People who are characterized by hypodynamia. That is a sedentary lifestyle.
- Persons who practice severe restrictions onnutrition, curative fasting, whose diet is unbalanced and irrational.
- People who practice intense or exhausting physical activity.
Where to go?
Where can densitometry be done? Today, the procedure is available in both public and private medical clinics. Its main goal is the timely diagnosis of osteoporosis, the detection of the disease at an early stage. As well as determining the predisposition to pathological changes in bone mass.
The referral for densitometry of the hip joint and other parts of the skeleton is given by a rheumatologist. But other narrow specialists can also suspect a violation and prescribe a similar diagnosis to the patient:
- Endocrinologists.
- Orthopedists.
- Gynecologists.
How is the diagnosis?
Before densitometry, specialists must determine the area of study of a part of the skeleton. It is from this location that the choice of methods for implementing this procedure will depend.
It is possible that during the densitometry, the patient, at the direction of the doctor, will need to change the position of his body. On average, this procedure takes 15-20 minutes. But the very course of this event directly depends on which research method was chosen.
Ultrasonic procedure
What does densitometry show? The concentration of calcium in bone mass. This indicator can also be determined during ultrasonic densitometry. Asthis is a non-radiological diagnosis, it is allowed once and for pregnant and lactating women.
A special device is used - a portable densitometer. It measures the speed at which ultrasonic waves travel to the bone tissue. Speed indicators here will be recorded using special sensors. Data from them, in turn, enters the computer, where it is processed by the system. Then they are displayed on the monitor.
Ultrasonographic densitometry is most commonly used to examine the heel bones. The method is valued for the speed of the procedure - it takes no more than 15 minutes. It is painless, does not have a toxic effect on the patient's body. In addition, the procedure is available to many in material terms.
Another advantage of this method is that a special room is not required for a diagnostic event. A mobile device is used, in a special recess in which it is necessary to place the part of the body to be examined - the elbow, forearm area, heel, fingers). The device works literally for 5 minutes - during this time all the necessary information is read.
As a rule, ultrasound densitometry is prescribed when examining for osteoporosis. But this is the first step. It is imperative to confirm the diagnosis with an x-ray.
X-ray procedure
X-ray densitometry gives more accurate results than ultrasound. The essence of this event is to determine the level of attenuation of the x-ray beam when it passes through the thickness of the bone tissue. The indicator is estimated by special equipment. The algorithm calculates the volume of minerals that were encountered in the path of the X-ray beam.
Densitometry of the femoral neck is most often X-ray. Also, this technique is used in relation to the wrist joints, the lumbar spine, the upper parts of the femur, the skeleton in general or its individual locations.
This method does not avoid irradiation (but in the minimum dose) of the patient. X-rays are known for their negative impact on the human body when exposed to it in large volumes. Therefore, frequent x-ray examinations for a short period of time are not recommended.
Also a contraindication to X-ray densitometry is pregnancy, lactation and a number of pathological conditions. For this method, expensive equipment is also used, which can only be placed in specially equipped rooms. All this is reflected in the cost of the procedure, its availability.
The patient is located on a special soft table, the radiation generator is located below it, and the image processing equipment is on top. It is important that you do not move while taking this X-ray so as not to blur the image.
After the patient has taken the required position, a special device passes over him, from which information is transmitted to the computer. It is processed by the system, converted into a snapshot.
Computer procedure
Main goalcomputer examination for osteoporosis is the determination of the density of the bone masses of the spine. With the help of such a procedure, it is realistic to identify the initial pathological changes in the structure of the vertebrae, to diagnose osteoporosis at an early stage of development. Computed tomography allows you to provide a report on bone density in three projections.
With the help of CT it is possible to accurately determine the localization and extent of tissue damage. This densitometry is mainly prescribed for deep bone injuries.
How dangerous is this?
Isn't such a diagnosis dangerous for he alth? This question worries many patients. But experts say that densitometry is completely safe for he alth.
The most harmless here is an ultrasound examination. It does not affect the state and functioning of internal organs. If densitometry is performed using X-ray, this also does not pose a danger to the patient. As we have already noted, the radiation doses here are minimal. Comparable to fluorography. Therefore, you can be sure that densitometry will not harm your he alth.
How often can a procedure be called?
Once again, we note that densitometry is a diagnostic examination that allows you to identify various disorders in the structure of bone tissue. In addition, it is possible to identify the volume, localization, degree of these changes.
Because it is a relatively safe method of research, densitometry can be prescribed up to several times a year. In somecases, it is shown monthly: when the pathology progresses too actively.
As for ultrasound examinations, they do not have any effect on the internal organs. Why you can pass this diagnostic an unlimited number of times.
What are the contraindications?
Are there any contraindications to the study of osteoporosis - densitometry? Again, it depends on the research method. Ultrasonic densitometry has no absolute contraindications. Therefore, this diagnostic method is used during pregnancy and lactation.
As for the technique using X-ray irradiation, it is shown only in specific cases. These are always pronounced violations of bone tissue in the area of the spine or femoral neck.
There are already contraindications for X-ray densitometry. These are pregnancy, breastfeeding and childhood. This technique is also not used for a number of diseases, since it requires a long-term fixation of the patient's body in a certain position. This is contraindicated for people with severe pathologies of the musculoskeletal system.
Preparing for the procedure
How is the preparation for densitometry going? No special events are required. Experts advise to follow only this list of simple rules:
- Discontinue calcium supplements 24 hours before your diagnostic procedure.
- It is worth coming to the examination in loose, easily unbuttoned clothes.
- You shouldn'tbe clothes with metal inclusions (locks, buttons, zippers). Accordingly, on the day of the examination, it is better to remove metal jewelry as well.
If your doctor is going to order a densitometry, be sure to tell him about the following:
- Have you had any barium treatments the day before.
- Has your relationship had a CT scan with contrast.
- Do you suspect pregnancy.
Deciphering the result of densitometry
Is it possible for a layman to understand the results of such a survey? In fact, the diagnosis of osteoporosis is made on the basis of only two indicators identified as a result of the study:
- T-test. It is obtained by comparing the obtained results of the bone density of the subject with the average values for his sex and age.
- Z-criterion. Here, the patient's bone density is compared to the average bone density of a person of his age. SD here is the unit of this density.
When deciphering the results of densitometry, pay attention to the T-test:
- Normal readings: +2.5 to -1.
- Osteopenia: -1.5 to -2.
- Osteoporosis: -2 or below.
- Severe osteoporosis: less than -2.5 with at least a single bone fracture from a minor cause.
Now about the Z-criterion when deciphering the results of densitometry. If it is too high or too low, then the following is additionally assigned:
- Biopsybone tissues.
- Biochemical examinations.
- X-ray.
But nevertheless, it is better to entrust the interpretation of the results of densitometry to a specialist. If necessary, he will prescribe additional diagnostics and draw up an individual treatment regimen.
