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Bone Densitometry

Bone Densitometry

People with osteoporosis suffer from a reduction in their bone mass and bone quality - put simply, their bones become fragile, leading to an increased risk of fractures. Bone density loss is usually gradual and without noticeable symptoms. The only reliable way to determine loss of bone mass is to have a bone mineral density (BMD) test.


Who should be tested?
Ideally, everyone at risk.

 

Strong risk factors for osteoporosis include:

  •  Oestrogen deficiency
  •  Early menopause (age <45 years) 
  •  Absence or cessation of menstrual periods (amenorrhoea >1 year) 
  •  Primary or secondary hypogonadism in both genders.
  •  Prolonged corticosteroid therapy (prednisolone, or equivalent, 7.5 mg or more daily with an expected use of 3 months or more)
  •  Maternal family history of hip fracture 
  •  Low body mass index (<19 kg/m2)
  • Chronic disorders associated with osteoporosis: anorexia nervosa, malabsorption syndromes including chronic liver disease and inflammatory bowel disease, primary hyperparathyroidism, post-transplantation, chronic renal failure, hyperthyroidism, prolonged immobilisation, Cushing's syndrome
  • Previous fragility fracture, particularly of the hip, spine or wrist
  • Loss of height, thoracic kyphosis (widow's hump)

Other risk factors:

  • Female (women are more at risk than men) 
  • Asian or Caucasian 
  • Diet low in calcium 
  • Lack of exercise 
  • Smoking
  • Regular and excessive alcohol consumption

 

People with a strong risk of osteoporosis are advised to consult their doctors for a bone mineral density test. In the USA, for example, guidelines recommend that all women aged 65 and up should have a BMD test and that postmenopausal women under age 65 who have one or more risk factors (in addition to being postmenopausal and female) should have a BMD test.

Diagnosis of osteoporosis


The most common diagnostic tool is a bone mineral density (BMD) test. This is a painless and non-invasive scan which, depending on the technology, measures bone density in the hip, spine, wrist, heel or hand. According to World Health Organization (WHO) guidelines, a BMD score in a postmenopausal Caucasian woman that is more than 2.5 standard deviations below the average for the young healthy female population implies a diagnosis of osteoporosis. For every standard deviation (SD) below peak bone mineral density, fracture risk increases by 50% to 100%. The same BMD values are being provisionally used for men because currently data on BMD and fracture in men is sparse. 
 

The importance of early diagnosis

 

Through early detection people with osteopaenia (low bone mass) or osteoporosis can take action to stop the progressive loss of bone mass. By making positive lifestyle changes and by following appropriate treatment strategies in consultation with a doctor, osteoporosis can be prevented and treated

 

Preparation for a BMD

 

No special preparation is necessary.  If you have had a barium examination very recently, please notify reception.  Booking is essential. 

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