Here are some common diagnostic tests that can be used to uncover the underlying causes of osteoporosis:
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The Bone Health & Osteoporosis Foundation suggests that you get a bone density test if you: 2
When these tests show decreased bone density, a DXA scan may be performed for confirmation. Other diagnostic imaging tests that may be done to measure BMD and to detect osteoporosis include CT scans (computerized tomography), X-rays, and ultrasounds.
Regardless of your sex or age, your doctor may recommend a bone density test if you've:
Know Your Osteoporosis Blood Test MarkersBone-specific alkaline phosphatase (Bone ALP or BALP). This is an estimate of the rate of bone formation over your entire skeleton. ... Osteocalcin. This is another marker of bone formation.Urinary N-telopeptide of type I collagen, or uNTX. ... Vitamin D levels.
To diagnose osteoporosis and assess your risk of fracture and determine your need for treatment, your doctor will most likely order a bone density scan. This exam is used to measure bone mineral density (BMD). It is most commonly performed using dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry.
Blood tests are another method used to diagnose certain bone diseases. One example is osteoporosis, where blood tests are used to determine risk factors and rule out other illnesses.
Urea and electrolytes (U&Es) are the most frequently requested biochemistry tests. They provide useful information about several aspects of health, such as the volume of blood and its pH. The most important aspect of U&Es is what they tell us about kidney functioning.
When you're being treated for osteoporosis, your doctor orders a bloodor urine test. This reveals several markers -- levels of different enzymes, proteins, and other substances circulating in the body -- that provide clues about your disease and the progress of your treatment. Some of these measures include:
Heart Failure and the BNP Blood Test
Osteocalcin. This is another marker of bone formation.
This is an estimate of the rate of bone formation over your entire skeleton. Bone formation may sound like a good thing, but depending on the circumstances, too much can be bad. People with osteoporosisgenerally have BALP levels that are up to three times normal.
As a result, many women take bone drugs to cover up the real problem. It’s never discovered that they might be suffering from hyperparathyroidism, excessive loss of calcium in the urine, Celiac Disease, hypercortisolemia or any other of the hidden causes of osteoporosis.
Here are some common diagnostic tests that can be used to uncover the underlying causes of osteoporosis:
I can’t help but draw attention to the fact that generally when a man is shown to have osteoporosis by bone mineral density testing or because of a needless fracture, he is immediately given a series of tests looking for the causes of his bone weakening. Women with osteoporosis, on the other hand, are immediately told to take bone drugs.
Blood and urine tests can be used to identify possible causes of bone loss. Some of these tests include:
Biochemical marker tests of the blood and/or urine may help to estimate how fast you’re losing or making bone. X-Rays and Vertebral Fracture Assessments (VFAs) can show breaks in the spine.
Osteoporosis medicines are prescribed to reduce the risk of broken bones. BHOF encourages you to discuss your treatment options with your healthcare provider. Always look at both the risks and benefits of taking a medicine, including potential side effects.
A physical examination for osteoporosis involves measuring height and checking the spine. Many professionals will also question you about risk factors such as your diet, how much you exercise, smoking and drinking habits, family history, fracture history and other factors that may contribute to your risk of developing osteoporosis. They will also take into account your DEXA scan results, or results from other bone tests.
Dual energy x-ray absorptiometry (DEXA or DXA) is the most common way to diagnose osteoporosis. The DEXA scan measures bone mineral density (BMD) in a number of areas of the skeleton, such as the hip, lower spine or wrist. The scan uses a low dose of radiation (around 10% of the dose from a chest x-ray). In a DEXA scan, or peripheral DEXA scan, you lie still on a couch for no more than twenty minutes, while scanning equipment moves over the body, taking an image. From this information, a T score is obtained. The T score is the comparison of your results against the range of young adults that are healthy and have an average bone density.
DEXA scanning in the elderly can be difficult, as the spine may be affected by other disorders such as osteoarthritis. This means that some bones can appear denser during a scan than they actually are. Some DEXA scans may also incorporate vertebral fracture assessment or VFA, which allows spinal fractures to be detected more easily.
The T score is the comparison of your results against the range of young adults that are healthy and have an average bone density. A T score of below -2.5 means that a diagnosis of osteoporosis is confirmed; a score of between -1 and -2.5 is diagnosed as osteopenia – some loss of bone density, but not enough to be diagnosed as osteoporotic.
Ultrasound. Quantitative ultrasound (QUS) can assess bone density in legs, heels and fingers. It uses sound waves to assess BMD, although unlike DEXA, it cannot assess bones such as the hip and spine – often the bones with the highest risk of osteoporotic fracture. A heel (calcaneus) ultrasound takes only a few minutes.
This is a fracture risk assessment tool developed by the World Health Organization. It includes bone density scores and other information to estimate your fracture risk for a ten year period. It is often used for those with osteopenia, those over the age of 50, or those who have yet to start treatment for osteoporosis.
Additional tests such as blood calcium levels, urine calcium measurements and hormone levels can assist clinicians in identifying causes for bone loss, as there are some health conditions such as thyroid diseases that can cause secondary osteoporosis. Other lab tests, such as bone marker tests can also assess how fast bone is being lost or made.
A doctor will ask questions related to osteoporosis risk factors. A family history of osteoporosis increases your risk. Lifestyle factors, including diet, physical activity, drinking habits, and smoking habits can also impact your risk. A doctor will also review medical conditions you have and medications you may have taken. Symptoms of osteoporosis that your doctor will likely ask you about include any bone fractures that occurred, a personal history of back pain, a loss of height over time, or a stooped posture.
A common example is a dual energy X-ray absorptiometry (DEXA) scan. This painless, rapid test uses X-ray images to measure bone density and fracture risk.
According to the RSNA, the test takes anywhere from 10 to 30 minutes to perform. Doctors may also perform an additional test known as a lateral vertebral assessment (LVA). Since back pain is both a frequent symptom of vertebral fractures from osteoporosis and a common symptom in general, LVA has been assessed to determine whether it can help doctors differentiate osteoporosis from non-specific back pain. This test uses DEXA machinery to help determine if someone already has spinal fractures. The overall clinical utility of this test in the diagnosis and management of osteoporosis remains controversial.
According to the Radiological Society of North America (RSNA), a DEXA scan is the standard for measuring the density of a person’s bones and their risk for osteoporosis. This painless test uses X-rays to measure bone density. A radiation technologist performs a DEXA scan using a central or peripheral device.
DEXA imaging results include two scores: a T score and a Z score. The T score compares a person’s bone mass with a young adult’s of the same gender. According to the National Osteoporosis Foundation, the scores fall into the following categories:
Symptoms of osteoporosis that your doctor will likely ask you about include any bone fractures that occurred, a personal history of back pain, a loss of height over time, or a stooped posture.
What is osteoporosis? Osteoporosis is a condition that occurs when a person experiences significant loss of bone density. This causes bones to become more fragile and prone to fracture. The word “osteoporosis” means “porous bone.”. The condition commonly affects older adults and can cause height loss over time.
A bone mineral density test, sometimes just called a bone density test, examines segments of your bone through X-rays to detect osteoporosis.
Bone densitometry is a test like an X-ray that quickly and accurately measures the density of bone.
A bone density test determines if you have osteoporosis — a disorder characterized by bones that are more fragile and more likely to break. The test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones that are most commonly tested are in the spine, hip and sometimes the forearm.
Bone scans require an injection beforehand and are usually used to detect fractures, cancer, infections and other abnormalities in the bone. Although osteoporosis is more common in older women, men also can develop the condition. Regardless of your sex or age, your doctor may recommend a bone density test if you've:
Limitations of bone density testing include: Differences in testing methods. Devices that measure density of the bones in the spine and hip are more accurate but cost more than do devices that measure density of the peripheral bones of the forearm, finger or heel. Previous spinal problems.
The higher your bone mineral content, the denser your bones are. And the denser your bones, the stronger they generally are and the less likely they are to break.
Bone density tests are usually done on bones that are most likely to break because of osteoporosis, including: Lower spine bones (lumbar vertebrae) The narrow neck of your thighbone (femur), next to your hip joint. Bones in your forearm.
Bone density tests are easy, fast and painless. Virtually no preparation is needed. Be sure to tell your doctor beforehand if you've recently had a barium exam or had contrast material injected for a CT scan or nuclear medicine test. Contrast materials might interfere with your bone density test.
Limited insurance coverage. Not all health insurance plans pay for bone density tests, so ask your insurance provider beforehand if this test is covered.
Alendronate (Fosamax) is given to a client with osteoporosis. The nurse advises the client to?
To specifically prevent osteoporosis in postmenopausal women, increased calcium and vitamin D intake and weight bearing exercises (e.g. walking) are the best methods. A patient started Alendronate (Fosamax) once a week for the treatment of osteoporosis.
Osteoporosis is a degenerative metabolic bone disorder in which the rate of bone resorption accelerates and the rate of bone formation decelerates, thus decreasing bone density. Postmenopausal women are at increased risk for this disorder because of the loss of estrogen.
b )bisphosphonates prevent calcium from being taken from the bones.
A: Weight bearing exercises are beneficial in the treatment of osteoporosis. B, C, D: Although loss of bone cannot be substantially reversed, further loss can be greatly reduced if the client includes weight bearing exercises along with estrogen replacement and calcium supplements in their treatment protocol.
Incorrect. Medications with high risk for decreasing bone density include: heparin, loop diuretics, such as furosemide (which waste calcium), phenytoin, anastrozole (Arimidex) and other aromatase inhibitors used for breast cancer and leuprolide ( Lupron) and other androgen blockers used for prostate cancer.
In Margot's lumbar spine the lowest T-score measurement is -1.8. In the right trochanter the T-score is -0.9 and the left trochanter the T-score is -1.1. She has not had any fractures as an adult. Margot has multiple sclerosis and takes the following medications daily: Copaxone, Zanaflex, Paxil, Detrol and Provigil.
Raloxifene is used in women afraid of getting breast cancer, or in women who had breast cancer and are attempting to prevent recurrence (or cancer occurrence in the contralateral breast). The Women's Health Initiative Trial exposed increased risks of certain health conditions with the use of hormone therapy.
A 73 year-old woman has a T-score of -4.3 in her right hip, -4.7 in her left hip and has had several vertebral fractures in her lumbar spine. Her only known medical conditions are osteoporosis and hypertension. She has never had any surgeries. This woman may be a candidate for the following therapy: (Select ALL that apply.)
Denosumab (Prolia) and teriparatide (Forteo) may both be useful in this very high-risk patient. Due to her age she is not a reasonable candidate for estrogen.