Who needs to be examined
- All women over 65 and men over 70
- Postmenopausal women under 65 years of age with risk factors
- Anyone who has suffered a fracture with minimal trauma after 50 years of age
- With long-term use of glucocorticosteroids (more than 3 months)
- For rheumatoid arthritis, celiac disease, inflammatory bowel disease, hyperthyroidism, hyperparathyroidism
- With a decrease in height by more than 4 cm and severe stoop
- If a parent has a hip fracture
What does densitometry show?
Dual-energy X-ray absorptiometry (DXA) measures bone mineral density in the lumbar spine and femoral neck. The result is expressed by T-test.
- T-score from −1 and above is normal
- From −1 to −2.5 - osteopenia, decreased density
- −2.5 and below – osteoporosis
- −2.5 and below in the presence of a fracture - severe osteoporosis
Ультразвуковая денситометрия пяточной кости не заменяет DXA: она годится для скрининга, но не для постановки диагноза и контроля лечения.
Risk factors
- Female gender and menopause - a sharp drop in estrogen accelerates bone loss
- Age
- Taking glucocorticosteroids is the most important avoidable cause
- Smoking and alcohol abuse
- Low body weight
- Calcium and vitamin D deficiency, lack of exercise
- Heredity, especially maternal hip fracture
- Diseases: hyperthyroidism, hyperparathyroidism, celiac disease, rheumatoid arthritis, chronic kidney disease
Treatment
Calcium and vitamin D are essential, but they alone are not a cure for osteoporosis. Once the diagnosis is established, drugs that affect bone metabolism are needed.
- Vitamin D is required, the dose is selected according to the level in the blood
- Calcium - preferably with food: dairy products, cheese, greens, fish with bones; supplements for insufficient intake
- Bisphosphonates are a basic group of drugs, taken strictly on an empty stomach with plenty of water, after which you should not lie down for 30–60 minutes
- Other drugs - for intolerance or severe forms, including injection forms 1-2 times a year
- Densitometry control usually after 1–2 years
- Treatment is long; You can’t stop it on your own
Prevention of fractures
- Strength exercises and loads with body weight: walking, stairs, exercises with an expander - the bone is strengthened only with load
- Balance exercises to prevent falls
- Remove slippery rugs and wires from your home, provide lighting, install grab bars in the bathroom
- Get your eyesight checked and talk to your doctor about medications that cause dizziness.
- Shoes with non-slip soles and flat heels
- Quitting smoking and limiting alcohol
- Adequate protein intake