Osteoporosis |
Osteoporosis is a silent, progressive disease
characterized by decreased bone density and increased bone fragility, with a
consequent susceptibility to fracture.
In the United States, over 28 million people are at high risk of developing
osteoporosis. Up to 1.5 million fractures a year are attributable to
osteoporosis. Health care expenditures related to osteoporosis are over $14
billion per year.
Women are at the greatest risk. One third of Caucasian women over the age of 50
have osteoporosis, yet nearly 80% remain undiagnosed. After menopause, a woman�s
risk of suffering an osteoporotic spine or femur fracture is 30% or three times
that of a man�s.
Osteoporosis is a complex, multi-factorial disease
that may progress silently for decades � there may be no symptoms until
fractures occur. Bone loss is the major risk factor that can be modified in
mid-life to reduce fracture risk. Bone loss can be reduced by treatment, but it
is difficult to restore the microarchitecture of the skeleton once bone has been
lost. Early detection and intervention are crucial.
Osteoporosis used to be considered an inevitable consequence of aging. Today,
with new techniques for early detection and ever-increasing treatment options,
osteoporosis management can and should be a part of your practice.
Osteoporosis: | |
The Role of Densitometry |
Bone densitometry is an essential tool in
osteoporosis management. Densitometry assists physicians in diagnosis, fracture
risk assessment, and monitoring response to therapy.
Diagnosis of Osteoporosis Physicians utilize
bone densitometry to categorize patients as normal, osteopenic, or osteoporotic
following the World Health Organization (WHO) classifications. The patient�s
T-score (comparison to the young adult reference) is the critical variable in
diagnosis. Typically, both femurs and the spine are assessed, with the diagnosis
made using the lowest T-score. Patient examination, in addition to the T-score,
is key to diagnosing osteoporosis.
Fracture Risk Assessment Bone mineral density
(BMD) is the strongest tool to predict fracture risk, which increases
exponentially as BMD decreases. Femur BMD is recognized as the strongest
predictor of femur fracture risk, which has the highest morbidity, mortality and
cost of all osteoporotic fractures. A decrease of 1 standard deviation (SD) in
femur BMD corresponds to approximately a 3X increase in femur fracture risk. In
comparison, a 1 SD decrease in spine BMD corresponds to a 2X increase in spine
fracture risk.
Monitoring Changes in BMD Patients may return
for bone density tests every 1-3 years, depending on the expected rate of loss
and their clinical situation. BMD may increase over time as a response to
therapy, or it may decrease with disease progression or poor response to
therapy. Precision (reproducibility) of the BMD measurements is the key factor
in detecting changes in patient BMD over time.
GE Lunar bone densitometers continue to set new landmarks in clinical value with
high-performance applications, advanced clinical utility, and the unique enCORE�
software platform.
Osteoporosis: | |
Clinical Guidelines |
Defining Osteoporosis by BMD
The World Health Organization (WHO) has established
the following definitions based on bone density measurement at any skeletal site
in white women
Although these definitions are necessary to establish
the prevalence of osteoporosis, they should not be used as the sole determinant
of treatment decisions.
Who should have a bone density test?
The National Osteoporosis Foundation (NOF) is a
leading source of information about osteoporosis and bone measurement.
The NOF recommends women have a bone density test if
they are:
The NOF recommends
considering treatment if:
GE Lunar bone densitometers continue to set new
landmarks in clinical value with high-performance applications, advanced
clinical utility, and the unique enCORE� software platform.