Which techniques can assess for osteoporosis

University of Sheffield. FRAX fracture risk assessment tool. Accessed May 15, ACOG practice bulletin N osteoporosis. Obstet Gynecol. American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis——executive summary.

Endocr Pract. North American Menopause Society. Management of osteoporosis in postmenopausal women: position statement of the North American Menopause Society. Ann Intern Med. The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol. Clinical review: risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis.

J Clin Endocrinol Metab. Fracture risk and zoledronic acid therapy in men with osteoporosis. N Engl J Med. The effect of teriparatide [human parathyroid hormone ] therapy on bone density in men with osteoporosis.

National Center for Health Statistics. Healthy People Midcourse Review. Centers for Disease Control and Prevention. Physical activity and health.

Updated February 13, Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: US Preventive Services Task Force recommendation statement.

Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care. Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry. Gynecol Endocrinol. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int. Validation and comparative evaluation of the osteoporosis self-assessment tool OST in a Caucasian population from Belgium.

Bone-density testing interval and transition to osteoporosis in older women. Timing of repeat BMD measurements: development of an absolute risk-based prognostic model. Sheffield, United Kingdom: University of Sheffield; National Committee for Quality Assurance. Osteoporosis testing and management in older women. Reducing the need for central dual-energy X-ray absorptiometry in postmenopausal women: efficacy of a clinical algorithm including peripheral densitometry.

Calcif Tissue Int. Application of a triage approach to peripheral bone densitometry reduces the requirement for central DXA but is not cost effective. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. Effect of recombinant human parathyroid hormone on vertebral fracture and bone mineral density in postmenopausal women with osteoporosis: a randomized trial.

Preventive Services Task Force. International Society for Clinical Densitometry. Modified June 18, American Association of Family Physicians. Choosing wisely: DEXA for osteoporosis. Osteoporosis in men: an Endocrine Society clinical practice guideline.

Medicine Baltimore. This systematic review to support the US Preventive Services Task Force Recommendation Statement on osteoporosis screening summarizes published evidence on the benefits and harms of screening and treatment to prevent osteoporotic fractures in adults 40 years and older.

Save Preferences. Privacy Policy Terms of Use. This Issue. Views , Citations View Metrics. Twitter Facebook More LinkedIn. June 26, Article Information. Summary of Recommendations and Evidence. Benefits of Early Detection and Treatment. Osteoporosis and bone growth Bone is formed by specialised cells. Symptoms of osteoporosis Osteoporosis causes no specific pain or symptoms. Diagnosis of osteoporosis Currently, the most reliable way to diagnose osteoporosis is to measure bone density with a dual-energy absorptiometry scan or DXA.

You can qualify for a Medicare rebate for a DXA scan if you: have previously been diagnosed with osteoporosis have had one or more fractures due to osteoporosis are aged 70 years or over have a chronic condition, including rheumatoid arthritis, coeliac disease or liver disease have used corticosteroids for a long time.

Risk factors for osteoporosis There are many risk factors for osteoporosis, some of which you cannot change, such as being female, and having a direct relative who has had an osteoporotic fracture. Other risk factors include: inadequate amounts of dietary calcium low vitamin D levels cigarette smoking alcohol intake of more than two standard drinks per day caffeine intake of more than three cups of coffee or equivalent per day lack of physical activity early menopause before the age of 45 loss of menstrual period if it is associated with reduced production of oestrogen, which is vital for healthy bones the menstrual cycle can cease following excessive dieting and exercise long-term use of medication such as corticosteroids for rheumatoid arthritis, asthma and other conditions.

Some conditions place people at a higher risk of osteoporosis. Prevention of osteoporosis From a young age, both men and women can take steps to prevent osteoporosis by making sure that they: have a healthy and varied diet with plenty of fresh fruit, vegetables and whole grains eat calcium-rich foods absorb enough vitamin D avoid smoking limit alcohol consumption limit caffeine do regular weight-bearing and strength-training activities. Calcium-rich diet and osteoporosis Enjoying a healthy, balanced diet with a variety of foods and an adequate intake of calcium is a vital step to building and maintaining strong, healthy bones.

Vitamin D and osteoporosis Vitamin D and calcium promote bone density. Vitamin D can also be found in small quantities in foods such as: fatty fish salmon, herring, mackerel liver eggs fortified foods such as low-fat milks and margarine. Exercise to prevent osteoporosis Weight-bearing exercise encourages bone density and improves balance so falls are reduced.

General recommendations include: Choose weight-bearing activities such as brisk walking, jogging, tennis, netball or dance. While non-weight-bearing exercises, such as swimming and cycling, are excellent for other health benefits, they do not promote bone growth. Include some high-impact exercise into your routine, such as jumping and rope skipping.

Consult your health professional — high-impact exercise may not be suitable if you have joint problems, another medical condition or are unfit.

Strength training or resistance training is also an important exercise for bone health. It involves resistance being applied to a muscle to develop and maintain muscular strength, muscular endurance and muscle mass. Importantly for osteoporosis prevention and management, strength training can maintain, or even improve, bone mineral density. Be guided by a health or fitness professional such as an exercise physiologist who can recommend specific exercises and techniques. Activities that promote muscle strength, balance and coordination — such as tai chi , Pilates and gentle yoga — are also important, as they can help to prevent falls by improving your balance, muscle strength and posture.

A mixture of weight-bearing and strength-training sessions throughout the week is ideal. Aim for 30 to 40 minutes, four to six times a week. Exercise for bone growth needs to be regular and have variety. Lifestyle changes to protect against osteoporosis Be guided by your doctor, but general recommendations for lifestyle changes may include: stop smoking — smokers have lower bone density than non-smokers get some sun — exposure of some skin to the sun needs to occur on most days of the week to allow enough vitamin D production but keep in mind the recommendations for sun exposure and skin cancer prevention drink alcohol in moderation, if at all — excessive alcohol consumption increases the risk of osteoporosis.

Drink no more than two standard drinks per day and have at least two alcohol-free days per week limit caffeinated drinks — excessive caffeine can affect the amount of calcium that our body absorbs. Drink no more than two to three cups per day of cola, tea or coffee. Management of osteoporosis If you have osteoporosis, the strategies listed to prevent osteoporosis will help to manage the condition, but you may also need to consider: safer exercise options falls prevention medication.

Safer exercise options with osteoporosis If you have osteoporosis, the risk of a fracture break with high-intensity exercise and poorly performed strength training can outweigh the bone-building benefits of these exercises. The program may include: modified strength-training exercises weight-bearing exercise such as brisk walking gentle exercises that focus on posture and balance.

Falls prevention and osteoporosis A third of people aged over 65 years fall every year and six per cent of those falls lead to a fracture. Be guided by your doctor, but general recommendations include: Perform exercises to improve your balance as prescribed by a physiotherapist or exercise physiologist.

If you have prescription glasses, wear them as directed by your optician. An occupational therapist can help with this. Wear sturdy flat-heeled shoes that fit properly.

Consider wearing a hip protector. CT scan of the spine : CT scanning of the spine is performed to assess for alignment and fractures.

It can be used to measure bone density and determine whether vertebral fractures are likely to occur. MRI of the spine : Magnetic resonance imaging of the spine is performed to evaluate vertebral fractures for evidence of underlying disease, such as cancer, and to assess if the fracture is old or new. New fractures usually demonstrate a better response to treatment by vertebroplasty and kyphoplasty. There are many FDA-approved medications to choose from for the treatment of osteoporosis including: bisphosphonates calcitonin hormone therapy RANK ligand inhibitor selective estrogen receptor modulators SERMs parathyroid hormone analog.

Send us your feedback Did you find the information you were looking for? Yes No. Area Code:. Phone no:. Radiologist and patient consultation. View full size with caption. Sponsored By. Please note RadiologyInfo. Severe osteoporosis denotes osteoporosis in the presence of one or more fragility fractures.

The same absolute value for BMD used in women can be used in men. The recommended site for diagnosis is the proximal femur with dual energy X-ray absorptiometry DXA.