How is Osteoporosis Diagnosed?
Medical History and Risk Assessment
Your healthcare provider will begin by asking about your medical history, including any previous fractures, family history of osteoporosis, and your lifestyle habits, including diet, exercise, smoking, and consumption of alcohol. You may also be asked whether you have any existing medical conditions or are on any medications as they could lead to an increased risk of fractures and lower bone mass.
A physical examination may be performed to assess your posture, height, and any signs of curvature in the spine, which can be indicative of vertebral fractures. Your healthcare provider may examine your gait along with muscle strength.
Bone Density Test
Also known as DEXA, DXA, or Bone Density Scans, it is used to diagnose osteoporosis by measuring bone mineral density (BMD) in specific areas of the body, typically the hip, spine, or forearm. A T-score or Z-score is calculated to compare your BMD to that of a healthy young adult, and the score indicates the risk of osteoporosis.
What is a T-Score?
A T-score will be assigned if you are a postmenopausal woman or man aged 50 or older. It is calculated by comparing your bone mineral density (BMD) to that of a healthy young adult of the same sex. Here's what different T-scores mean:
1 or Higher:
It means your bone density is similar to that of a healthy young adult. This indicates that your bones are considered healthy and strong.
Between -1 and -2.5:
This suggests that you have osteopenia. Osteopenia is a condition where your bone density is lower than that of a healthy young adult but not severe enough to be classified as osteoporosis. It indicates that your bones are weaker than ideal but not at the level of osteoporosis.
Of -2.5 or Lower:
A score of -2.5 or lower is indicative of osteoporosis. This means your bone density is significantly lower than that of a healthy young adult, and your bones are at a high risk of fractures.
What is a Z-Score?
Unlike the T-score, which compares your bone density to that of a healthy young adult, the Z-score compares your bone density to that of individuals in your peer group. Z-scores are typically used for premenopausal women, men younger than age 50, and children. Here are what different Z-scores mean:
Of -2.0 or Less:
If your Z-score is -2.0 or lower, it suggests that your bone mineral density is significantly lower than what is typical for people of your age, sex, and, in some cases, ethnicity. This low Z-score may indicate low bone density, but it doesn't necessarily mean you have osteoporosis. Instead, it might suggest other factors such as medications or underlying medical conditions that are affecting your bone health.
What are the Treatments for Osteoporosis?
A range of different medications is used to treat Osteoporosis.
Bisphosphonates are a class of medications commonly prescribed to treat osteoporosis. They work by inhibiting bone resorption, which helps maintain bone density and reduce the risk of fractures. Some well-known bisphosphonates include alendronate, risedronate, and ibandronate. These medications are usually taken orally, as an injection or, in some cases, administered intravenously.
Denosumab is a medication that works by inhibiting bone resorption. It is administered via injection and can be an alternative for those who cannot tolerate or do not respond well to bisphosphonates. It also reduces the risk of fractures by improving bone density.
Supplements may be taken alongside medications or any other prescribed treatments by your healthcare provider.
Calcium is crucial in the prevention of brittle bones and is absorbed from a good diet, as well as natural sunlight. The majority of calcium absorbed goes towards the bones and teeth, which assist in maintaining their density and strength, while the rest goes to the rest of the body.
Food groups that provide a high amount of calcium include:
- Leafy green vegetables
- Canned salmon or sardines
- Beverages fortified with calcium
However, if you have an insufficient calcium intake, your medical provider may suggest having calcium supplements.
Vitamin D aids in calcium absorption, making it a vital nutrient for bone health and preventing brittle bones. This vitamin can be obtained by being exposed to natural sunlight and incorporating certain food groups into your diet, such as:
- Fatty fish
- Egg yolks
- Cod liver oil
Your healthcare provider can determine whether you need vitamin D supplements based on your dietary intake and individual requirements.
How Can You Prevent Osteoporosis?
You can keep your bones healthy through diet by having the minimal intake recommendation for Vitamin D and Calcium. However, this does not mean that certain food groups must be favoured above others, as other nutrients such as protein, potassium, and magnesium can also contribute towards preventing weak bones.
You can modify your home environment with fall prevention in mind. The first step is to identify and remove tripping hazards, such as loose rugs, clutter, and clearing blockages in the living space. Then ensure proper lighting at entryways, stairways, and hallways, to reduce the risk of missteps as well as falls. You may also want to consider adding handrails in bathrooms and stairs, for maintaining balance along with improving safety.
For individuals at a high risk of falls, assistive devices like canes or walkers can provide stability and reduce the likelihood of accidents.
Regular Bone Density Testing
A bone density test can determine whether you have osteoporosis or are at risk for developing it. It is carried out by using X-rays to measure the amount of calcium and bone minerals contained in a specific segment of your bones. The most common areas for these screenings to be carried out are in the hip, spine, and forearm. These screenings can assess your bone health and guide preventive measures and treatment if needed.
Are You or Your Loved Ones At Risk of Osteoporosis?
Osteoporosis is a condition that can easily go undetected, and early detection can improve treatment outcomes. Whether you or your loved ones are facing this condition, feel free to book an appointment with us at Avant Orthopaedics, and we will provide you with a personalized consultation.