Osteoporosis diagnosis

Measurement of central (hip and spine) BMD with dual-energy x-ray absorptiometry (DXA) is the gold standard for osteoporosis diagnosis. Measurement at peripheral sites (forearm, heel, and phalanges) with ultrasound or DXA is used only for screening purposes and to determine the need for further testing. 

Total synthesis of f-t -deoxypyiTobrine, a potential biochemical marker for diagnosis of osteoporosis, is shown in Eq 10 25 Osteoporosis is a cripphng degenerative bone disease that affects the aged populadon, particularly postmenopausff women... 

Once the bone mineral density report is available, T-scores and Z-scores are useful tools in interpreting the data. The T-score is the number of standard deviations from the mean bone mineral density in healthy young white women. Osteoporosis is defined as a T-score at least -2.5 standard deviations below the mean (Table 53-3). Osteopenia, or low bone mass that eventually may lead to osteoporosis, is defined as a T-score between -2.5 and -1.0 standard deviations below the mean. The International Society for Clinical Densitometry recommends use of the WHO definition and T-scores for diagnosis of osteoporosis in postmenopausal women and men... 

NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy (2001) Osteoporosis prevention, diagnosis, and therapy. The Journal of the American Medical Association,... 

The diagnosis of osteoporosis based on a low-trauma fracture or central hip and/or spine DXA using World Health Organization T-score thresholds. Normal bone mass is a T-score greater than -1, osteopenia is a T-score of-1 to -2.4, and osteoporosis is a T-score at or below -2.5. 

Increased concentrations in plasma of markers such as P1NP or cross-linked C-terminal telopeptides (CTx), or urinary excretion of DPD, indicate increased bone turnover but are generally not useful for initial diagnosis of osteoporosis. Changes in plasma concentrations or urinary excretion of bone markers may be useful for monitoring patients response to therapy. 

There have been reviews of the mechanisms and adverse effects of glucocorticoids in rheumatoid arthritis (205) and the pathogenesis, diagnosis, and treatment of glucocorticoid-induced osteoporosis in patients with pulmonary diseases (206). Several mechanisms underlie the effect of glucocorticoids on bone, both biochemical and cellular. Effects on calcium are ... 

While biochemical markers of bone metabolism may be sensitive to the effects of glucocorticoids in the short term, the relation between changes in these markers and intermediate measures, such as bone mineral density, and the more important clinical outcomes of fractures, is unknown. In a random stratified sample of 3222 women in the perimenopausal age range (47-56 years), including 119 women with asthma, bone mineral density was measured to determine whether asthma was a risk factor of osteoporosis and to investigate the effect of inhaled glucocorticoids (102). The subjects had predominantly adult-onset asthma, as the age at diagnosis was over 40 years. There were 26 patients who were treated mainly with... 

Olszynski WP, Davison KS, Adachi JD, Brown JP, Cummings SR, Hanley DA, Harris ST, Hodsman AB, Kendler D, McClumg MR, Miller PD, Yuen CK. Osteoporosis in men epidemiology, diagnosis, prevention and treatment. ClinTher 2004 26 15-28. 

Bone mineral density (BMD) is measured using dual energy X-ray absorptiometry (DEXA) usually at the neck of femur (on the hip). The World Health Organization defines a diagnosis of osteoporosis if the BMD is 2.5 standard deviations or more below the young adult female mean value. This difference is known as the T-score. Patients are considered to have osteopenia if the T-score is between -1 and -2.5. 

Patients can undergo a dual-energy X-ray absorptiometry (DEXA) scan to confirm the diagnosis of osteoporosis. Osteoporosis is defined as having a bone mineral density which is at least 2.5 standard deviations below the peak bone mass when measured by a DEXA scan (e.g. a T-score -2.5 SD or below). 

Are Bone Markers Useful in the Diagnosis of Osteopenia and Osteoporosis ... 

There is a great deal of both popular and professional interest in the etiology, diagnosis, prevention, and treatment of osteoporosis. The extent of this disease in the United States is a major public health concern. No single cause can be identified. Certainly the influence of hormones, dietary intakes of Ca, fluoride and vitamin D are significant. Our results suggest that it may be prudent to consider the possibility that trace element deficiencies, particularly of Mn, may be of significance. 

Ideally, diagnosis of osteoporosis should be made prior to the occurrence of symptom-causing fractures. Various radiologic techniques are available to measure the density (solidity) of bone, and include x ray and CT (computed tomography) examinations of the spine, femur, and wrist bones. 

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