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Diagnosing Osteoporosis

In order to be able to diagnose osteoporosis it is necessary to measure the patient's bone density. A number of techniques are available for this purpose.

Read more about the techniques used for measuring bone density

Osteoporotic Spine

Bone density values in individuals are expressed in relation to a reference in Standard Deviation  (SD) units. This reduces the problems associated with differences between the various measuring instruments, it does however require defined “normal” ranges.

If bone mineral density (BMD) is below 1 SD but not below 2.5 SD of the mean value of peak bone mass in young normal women, than there is a low bone mass (Osteopenia). If this value is greater than 2.5 SD below this value the patient has Osteoporosis.

This definition is definitely not perfect but reasonable well for diagnostic and therapeutic considerations.

Osteoporosis is a-symptomatic until a fracture occurs. The risk of fracture is inversely related to bone mass. As bone mass decreases, the risk of fracture increases.

Even relatively small alterations in bone mass can lead to significant changes in the risk of fractures.

The most common sites of fracture in osteoporotic patients are the vertebrae, the hip, and the forearm.

Osteoporotic fractures are associated with significant morbidity and mortality. The most important complaint of patients with osteoporosis is acute or intermittent back pain following normal activity. The pain usually lasts a few days or weeks and then subsides. Such episodes recur and may result in chronic backache. The episodes are due to crush fractures of vertebrae. As the disease progresses, loss of height, spinal deformity and fractures occur.

Hip fractures, in particular, frequently have grim prognosis. The mortality rate of osteoporotic hip fractures is between 15 % and 20 %, primarily due to pulmonary emboli, pneumonia, and other complications of surgery and prolonged hospitalization. The lifetime risk of hip fractures in white women is as great as the risk of breast, endometrial and ovarian cancer combined. One half of patients who survive a hip fracture are unable to walk unassisted and 25 % are confined to nursing homes. In up to 20 % of hip fractures the patient dies within 6 months