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Diagnosing Osteoporosis - What gives the best results?

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20 Aug, 2018

Unless there is a bone injury or a fracture, detection of osteoporosis is not really possible. An X-ray of a fractured bone helps in detecting the condition, though not with high accuracy.

For best diagnostic results, Dual-energy X-ray absorptiometry (DEXA) is a better choice. DEXA scans are often used to diagnose or assess the risk of osteoporosis. Because of its ease of use, low radiation exposure (less than one-tenth of the dose of chest x-ray radiation), and ability to measure BMD at both the hip and spine, DEXA is the most commonly used technique to measure BMD.

 

The results of DEXA scans help the Doctor to decide whether treatment for low bone mineral density is needed. Comparison of the bone density measurements is done with the bone density scores of a young healthy adult or an adult of the same age, gender, and ethnicity.

The normal range for bone density measurements (T score) is between 0-1. If the bone density is in the range (-1 to -2.5) it is diagnosed osteopenia, and if it is below - 2.5 then it is diagnosed as osteoporosis.

In 2013, estimates from a study suggested that approx. 50 million people in India had T-scores of <−1. The World Health Organization (WHO) has created a 10-year Fracture Risk Assessment Tool, which applies to both men and women between 40 and 90 years of age. The tool can be used to assess if a DEXA scan is appropriate and calculates the risk of fracture in the next 10 years.

 

Limitations of Dexa Scan

  • A DEXA test cannot predict who will experience a fracture but can provide indications of relative risk. Other risk factors need to be taken into consideration, such as family history and medication use, to determine who's at risk of developing bone fractures.
  • Despite its effectiveness as a method of measuring bone density, DEXA is of limited use in people with Spinal abnormalities or previous spinal fractures as it may give a false result. In such instances, CT scans may be more useful.
  • A DEXA scan won't show whether low bone mineral density is due to osteoporosis (too little bone) or osteomalacia (too little calcium in bone, usually due to a lack of vitamin D).