How to Know if You Have Weak Bones

Bone Density Testing

Are yous a woman age 65 years or older, a man historic period 70 years or older, or have you broken a bone (had a fracture) since age l years? If you answered "yes" to any of these questions, you lot should talk to your healthcare provider about getting a bone density test. Read on to learn about this, and more than!

What Is a Bone Density Test?

DXA is a non-invasive test to measure out bone density.

A bone density exam is a measurement of how much mineral, such as calcium, you have in your bones. The most common and most versatile examination is with dual-energy X-ray absorptiometry (DXA). This is used to diagnose osteoporosis Before yous break a bone, assist to approximate your chances of breaking a bone in the future, and monitor the effectiveness of osteoporosis treatments. This is a very simple test that only takes a few minutes to do. You do non need to undress, but y'all must not have buttons or zippers in the area over your spine and hips. The test is not-invasive and painless; no needles or instruments are placed through the pare or body. There is very little radiation – far less than what yous would get on a cross-country aeroplane flight. You but lie on a DXA table and follow the instructions of the technologist to run across that you are correctly positioned. And then a movable arm passes above you to scan your bones. Although this is very easy for you, the technology of the scan and computer system is actually very sophisticated. It requires highly trained staff to do the test properly and a qualified person to interpret it correctly. A expert style to check on the qualifications of the person doing the DXA test is to ask whether they are certified by an arrangement such as the International Order for Clinical Densitometry (ISCD).

How Is Osteoporosis Diagnosed?

There are 3 means that osteoporosis can be diagnosed. For each of these, confirmation of the diagnosis requires an evaluation to be sure at that place is no other disease or condition that appears to exist osteoporosis but is not.

1. Bone mineral density – The output of a DXA test is a number chosen a T-score. Normal is zero (0). The more negative the number, the weaker your basic and the more than likely they are to break. If your T-score is -2.5 or below (such as -iii.0), then you lot take osteoporosis, assuming at that place is no other reason for yous to accept such a low T-score.
2. Fracture – If y'all are over the historic period of 50 years and accept had a fracture of the spine, hip, wrist, humerus (shoulder), rib, and/or pelvis, then you lot probably have osteoporosis. A fracture of the spine or hip means osteoporosis regardless of your T-score. The occurrence of a fracture suggests that your basic are weaker than they should be and that farther evaluation may be needed. In older adults, even fractures with major trauma, such as an auto accident, may be a sign of osteoporosis.
3. FRAX – FRAX is a fracture take chances calculator that is included in the software of most DXA systems and is attainable online for anyone at https://www.sheffield.air-conditioning.uk/FRAX/tool.aspx?country=nine. With input of your bone density, your age, sexual practice, peak, weight, and answers to 7 questions, FRAX calculates the chances of you lot having different types of fractures in the next ten years. If your 10-twelvemonth probability of major osteoporotic fracture (significant a fracture of the spine, hip, shoulder, or forearm) is 20% or more than, or the 10-year probability of hip fracture is three% or more, and then a diagnosis of osteoporosis can exist made.

Who Should Have a Bone Density Test?

Who should accept a bone density test?

• Women age 65 years and older
• Men historic period 70 years and older
• Anyone who has cleaved a os later on age 50 years
• Women age 50-64 years with chance factors*
• Men historic period l-69 years with risk factors*

*Examples of chance factors for osteoporosis and fractures include family history of osteoporosis and/or fracture, frequent falling, vitamin D deficiency, smoking, excessive alcohol intake, malabsorption, and some medications, such as prednisone.

Tin can DXA Do More than Measure Bone Density?

DXA can be used to evaluate your os health in ways that get across measuring bone density. Here are some of the other applications of DXA. These tests are available at some but not all DXA facilities.

1. Vertebral fracture assessment (VFA) – This is a sideways prototype of the spine that can detect fractures, or crushed basic, in the spine. About people who accept these fractures exercise not know they are there. Identifying a previously unrecognized spine fracture may change your diagnosis, the estimation of your fracture chance, and handling plans.
2. Trabecular bone score (TBS) – This a number representing the internal structure of bones in your spine at the microscopic level. The higher the number, the better. Information technology is generated with the use of special software added to the DXA system. The TBS number can be included in FRAX to give a ameliorate assessment of fracture risk.
3. Total-length femur imaging (FFI) – FFI is a technique for using DXA to get an image of your entire femur (thigh bone), instead of just the area around the hip that is seen with standard DXA. This can brand it possible to recognize thickening of the bone that could lead to a stress fracture, or atypical femur fracture.
4. Hip structural analysis (HSA) – The size, shape, and configuration of your hip basic can influence the forcefulness of your hip and the likelihood of it breaking. HSA with DXA provides a way to await at this and may sometimes assistance with treatment decisions.

Are There Other Tests For Bone Density And Bone Health?

Many tests other than DXA can be used to assess your os wellness. Some of them are not every bit widely  widely used equally DXA, simply they may provide useful data, provide information beyond bone density, or help to determine who needs a DXA.

Quantitative Computed Tomography (QCT)

QCT provides a 3-dimensional measurement of bone density and can generate numbers that tin exist used to diagnose osteoporosis and for input with FRAX. Almost types of QCT tests provide the same type of T-scores for bone mineral density at the hip every bit does DXA, merely at the spine can provide a measurement of bone mineral density of just the spongy bone inside your vertebra. This type of spinal measurement may be preferred if your spinal basic accept degenerative disease.  QCT is not every bit widely used as DXA due to limited availability, higher radiations dose, and being less applied to monitor handling for most patients.

Biomechanical Computed Tomography (BCT)

BCT is an advanced engineering science that uses data from a CT scan to measure out bone mineral density.  It is most usually run on a CT scan you lot accept already had or will take as office of clinical care for any reason as long equally the scan includes an paradigm of your hip and/or lower spine (for example an abdominal/pelvic CT scan to evaluate abdominal hurting). BCT also uses technology analysis (finite element analysis or FEA) to estimate os strength (or measure the breaking strength of bone).

Radiofrequency Echographic Multi Spectrometry (REMS)

REMS is a portable method that does not use radiation that gives bone density measurements of the hip and spine.

Tests at Peripheral (Non-spine, non-hip) Sites

These types of tests measure out bone density or other parameters in the peripheral skeleton, namely the arm, leg, wrist, fingers, or heel. Examples include:

• pDXA (peripheral dual energy ten-ray absorptiometry)
• pQCT (peripheral quantitative computed tomography)
• QUS (quantitative ultrasound) – QUS, which is portable and uses no radiation, can exist used to estimate fracture adventure but cannot diagnose osteoporosis and is not useful to monitor treatment.

The results from these types of tests are not comparable to primal DXA measurement and therefore difficult to interpret for diagnostic purposes and thus additional testing is often required. These types of tests serve generally every bit screening tests to help identify people who are likely to benefit from further bone density testing at the hip and/or spine. Screening tests cannot accurately diagnose osteoporosis and should non be used to see how well an osteoporosis medicine is working.

• Pulse-repeat ultrasound (P-EU) – uses no radiations and measures the thickness of cortical bone at peripheral skeletal sites with a handheld device. Studies have shown a significant correlation between measurements from P-Eu and bone mineral density measured by DXA at the hip.

Where to Have a Bone Density Test

Most people need a prescription or referral from their healthcare provider to have a bone density examination. If you're non certain where to go for a bone density examination, contact your healthcare provider or your insurance program to find out where the test is bachelor. The ideal facility is one with staff that are trained and certified by an system such every bit the ISCD, and better yet, ane that has been accredited by the ISCD. Most infirmary radiology departments, private radiology groups, and some medical practices offer os density testing. When you get for your engagement, be sure to have the prescription or referral with you. The testing center will send your bone density test results to your healthcare provider. You lot may want to make an appointment to discuss your results with your healthcare provider.

When to Repeat a Bone Density Test

As with whatsoever medical test, os density should exist repeated when the results might influence handling plans. Information technology is often repeated 1-2 years after starting or changing osteoporosis medication to evaluate response to treatment. It might also exist repeated in 1-two years if you are non beingness treated only are shut to a treatment threshold. Subsequent testing varies according to your private situation.

Understanding DXA Results

For postmenopausal women and men age 50 years and older, the T-score is the number that is used for diagnostic nomenclature, as follows:

• A T-score of -i.0 or above is normal bone density. Examples are 0.9, 0 and -0.nine.
• A T-score between -1.0 and -2.5 means you take low os mass or osteopenia. Examples are T-scores of -i.ane, -1.six and -ii.four.
• A T-score of -two.5 or beneath is a diagnosis of osteoporosis. Examples are T-scores of -2.6, -3.3 and -3.9.

It is of import to recognize that you may be diagnosed with osteoporosis when the T-score is amend than -2.5, as when you have already had a broken bone or FRAX shows that your gamble is loftier. Too, when the T-score is ii-5 or below, you lot could have disease other than osteoporosis, such equally osteomalacia or multiple myeloma. Your healthcare provider tin can evaluate y'all to be sure the diagnosis is correct or refer you lot to someone who can.

When to Consider Medications for Osteoporosis

The results of your bone density test, combined with all available clinical data, including your personal preference and previous experience with medications, tin can help with deciding to start, continue, or change medication to brand your bones stronger and reduce the chance of breaking basic. Medications have been tested and approved for prevention and for treatment of osteoporosis. Each of these medications has its pros and cons. If you demand take a medication, any one of them may be meliorate than none, but some are better than others for increasing bone density and reducing the chance of breaking bones. Talk with your healthcare provider to find out which is best for yous. If you make up one's mind not to take a medication, it is often a good idea to monitor your bone density and reconsider your treatment decisions from time to fourth dimension. Regardless of whether you accept a prescription medication, remember the essentials for practiced bone health: regular weight-bearing and musculus strengthening physical action, maintaining skilful residue, avoiding falls, acceptable intake of calcium and vitamin D, not smoking, avoiding excessive booze intake, and when possible, fugitive or minimizing exposure to drugs that are harmful to bones, such as prednisone.

drapergreleige.blogspot.com

Source: https://www.bonehealthandosteoporosis.org/patients/diagnosis-information/bone-density-examtesting/