X-ray densitometry

The research is conducted in order to:

• Identification of a pathological decrease in bone mineral density and the degree of bone mass reduction.
• Evaluation of structural changes in bone tissue.
• Evaluation of bone strength characteristics.
• Determining the risk of fractures (using a special program, the FRAX calculator).
• Evaluation of the consistency and uniformity of bone mineral density reduction.
• Identification of conditions preceding osteoporosis.
• Determination of the dynamics of pathological changes and the effect of treatment.
• Diagnosis of osteoporosis.
Densitometry of the lumbar spine and femoral neck is most often performed, as fractures of the above-described sections dramatically reduce the quality of life and cause long-term limitation of the patient's mobility. In addition, the bone mineral density of the forearm is often assessed.

Types of X-ray densitometry

• quantitative ultrasound (KUDM),
• Dual-energy X-ray absorptiometry (DRA or DXA)
• quantitative computed tomography (CT).
• Worldwide and in Russia, dual-energy X-ray absorptiometry or X-ray osteodensitometry is considered the gold standard.

Indications and contraindications for densitometry

General indications:

• establishment or confirmation of the diagnosis of osteoporosis, according to WHO recommendations;
• forecasting the risk of fractures depending on the degree of decrease in BMD;
• monitoring the dynamics of patients' condition during therapy or without treatment.

At risk of decreased bone mineralization:

• Women over the age of 40 (risk of postmenopausal osteoporosis) and men over the age of 60 (risk of postandropausal osteoporosis).
• Women who have had multiple births, as well as breast-feeding for a long time (more than 9 months).
• Early menopause before the age of 45 (including surgery).
• Patients with various forms of calcium-phosphorus metabolism disorders.
• Patients with endocrine system disorders (Itsenko-Cushing's disease and syndrome, thyrotoxicosis, hypogonadism, hyperparathyroidism, insulin-dependent diabetes mellitus, hypopituitarism).
• Patients with low-energy fractures (under the influence of a force that cannot cause a fracture of a healthy bone) with minimal injuries, especially if less than 5 years have passed since the previous fracture.
• Patients with rheumatic diseases (rheumatoid arthritis, SLE, ankylosing spondylitis).
• Patients with diseases of the digestive system (condition after gastric resection, malabsorption syndrome, chronic liver diseases).
• Patients with kidney diseases (chronic renal failure, renal tubular acidosis).
• Patients with blood diseases (myeloma, thalassemia, systemic mastocytosis, leukemia and lymphoma).
• Patients with genetic disorders (osteogenesis imperfecta, Marfan syndrome, Ehlers-Danlos syndrome, homocystinuria, lysinuria).
• Patients taking drugs that reduce bone density (corticosteroids, hormonal contraceptives, anticonvulsants, immunosuppressants, gonadotropin-releasing hormone agonists, antacids containing aluminum, thyroid hormones).

• tendency to fall (for various reasons);
• physical inactivity (including bed rest for more than two months, use of a wheelchair and other auxiliary means of transportation, immobilization);
• organ transplantation;
• anorexia nervosa;
• chronic obstructive pulmonary diseases;
• unbalanced diet (insufficient content of calcium and vitamin D in food, consumption of large amounts of caffeinated drinks), observance of various fasting diets, therapeutic fasting, etc.;
• smoking and alcohol abuse.

Contraindications

• pregnancy and lactation,
• the presence of metal implants and metal structures in the study area,
• recent injuries and other conditions that make it impossible to remain motionless during the study,
• contrast studies (intravenous contrast studies, passage of barium contrast through the gastrointestinal tract, X-ray of the esophagus, stomach and duodenum using contrast agents, irrigoscopy/irrigography) or with the introduction of radiopharmaceuticals conducted 72 hours before the expected densitometry and earlier.

Preparation and carrying out of densitometry

How is densitometry performed

What does densitometry show and how is the result interpreted