It is known that calcium reserves in the body begin to deplete starting at the age of 30. Therefore, it is important to get diagnosed as early as possible, especially for women. For these purposes, a new technique has been developed - bone densitometry. This research method allows you to quickly and accurately determine bone mineral density.

What is the difference between ultrasound and x-ray bone densitometry?

The two types of surveys described are based on fundamentally different influences.

The first indicated technique involves establishing mineral density using densitometry of the calcaneus and radius. Ultrasonic vibrations pass through the tissue faster, the denser it is. The data obtained in this way is processed by a computer, the results are given in the form of indices showing deviations of calcium concentration from normal values. This method is considered very accurate, as it allows you to diagnose osteoporosis at a very early stage.

X-ray densitometry is the taking of photographs of the lumbar and thoracic spine in a lateral projection. In this case, bone density is calculated using special equipment based on the obtained images.

As a rule, the ultrasound method is called more informative, but after such densitometry, a full X-ray examination is prescribed to confirm the diagnosis.

Preparing for bone densitometry

No special preparation measures are required before the examination. The only requirement is not to take it 24 hours before densitometry.

1. Wear comfortable, loose clothing without metal fasteners, zippers or buttons.
2. Remove jewelry and glasses.
3. Warn your doctor about possible pregnancy.

It is worth noting that there is no need to prepare before ultrasound diagnostics; it is a very simple and quick procedure.

How is computer bone densitometry performed?

Monoblock ultrasound devices have a small niche into which a foot, finger or hand fits. After 15 minutes (sometimes less) of painless exposure, the measurement results are displayed on the computer. The diagnosis is established on the basis of two integral indicators - T and Z. The first value corresponds to the ratio (in points) of the measured bone density with the same value in healthy people under the age of 25 years. The Z-score reflects the calcium concentration compared to normal levels of the mineral in the patient's corresponding age group.

Scores exceeding -1 point are typical for healthy people. Values ​​in the range from -1 to -2.5 suggest the presence of osteopenia, the initial stage of bone demineralization. If the score is below -2.5 points, there is reason to diagnose osteoporosis.

How is X-ray bone densitometry performed?

Stationary examination systems consist of a table with a soft surface where the person is located (lying down), as well as a mobile “sleeve” that moves along the body and is localized above patient. Additionally, there is a shaped bracket into which the legs are placed when taking a picture of the hip joint.

An X-ray generator is built into the table, and a device for digital processing of the resulting images is built into the sleeve. After densitometry, they are displayed on the computer screen.

During the procedure, it is important to lie still and not move; sometimes specialists ask you to hold your breath for a short time to avoid blurring the picture.

The radiologist describes the results, providing estimates of bone calcium concentration and tissue density.

What is densitometry? Densitometry is a modern instrumental diagnostic technique that allows you to determine the mineral density and structure of bone tissue, as well as the thickness of the bone layer.

First of all, densitometry is carried out to identify osteoporosis, a disease accompanied by a decrease in the density and strength of bone tissue.

Such an examination has an important diagnostic value, since it allows timely identification and determination of the extent of damage to the human skeleton. Early diagnosis facilitates timely initiation of treatment, which significantly reduces the risk of pathological development of the disease. Most often, densitometry is performed on the lumbar spine, hip bones, and femoral neck. In some cases, the entire skeleton is assessed.

There are two main types of densitometry:

1. Ultrasound densitometry. Used as a primary diagnosis. Ultrasound of joints and bones does not have highly accurate information content, but is characterized by the highest safety and therefore can be used many times. However, it can be used to determine the degree of elasticity and stiffness of bones, as well as determine bone density.
2. X-ray densitometry. The data from such a survey is as accurate as possible. Since the duration of the procedure is short, the dose of x-ray radiation received does not pose a health hazard.

Usually, if osteoporosis is suspected, ultrasound densitometry is initially prescribed; if the suspicions are justified and certain parameters need to be clarified, an X-ray examination is performed.

In what cases is densitometry indicated?

It is known that bone densitometry is performed to determine the presence and degree of osteoporosis. Therefore, it is considered advisable to conduct such an examination in individuals at risk for this disease.

These are considered to be the following:

• persons who received a fracture due to minor injuries;
• women during menopause, especially if it occurs before the age of 50;
• people leading a sedentary lifestyle;
• persons taking glucocorticoid drugs for the treatment of rheumatic diseases;
• persons who have been taking medications for a long time that wash away calcium from the bones;
• persons with a history of diseases of the endocrine system;
• men and women who are underweight;
• anyone who has suffered any bone injuries or suffers from pain in the lumbar spine;
• men over 60 years of age.

X-ray examination, unlike ultrasound of the spine, is not carried out for pregnant women and women breastfeeding.

Bone densitometry is not performed if a radioisotope examination was performed two days before the proposed procedure and a computed tomography or magnetic resonance imaging using a contrast agent was performed 5 days before.

How is the diagnostic procedure performed?

Diagnosis of osteoporosis is absolutely painless, does not injure or cause discomfort in the patient. No special preparation is required before undergoing the procedure. It is recommended that a few days before the procedure, exclude calcium-rich foods (cottage cheese, cheese) from the diet and not use medications containing phosphorus and calcium salts internally. It is necessary to inform your doctor in advance about any pacemakers or metal implants you have. It is important to keep your body still during the procedure. There is no need to free the body from clothes. The duration of the procedure is about 30 minutes.

How is densitometry performed? To begin the procedure, the patient must lie horizontally on the couch. Above it there is a special sensor that will read information by measuring the intensity of X-rays.

The location of the body will depend on which area of ​​the body will be examined. When examining the bones of the spine or its specific part, the legs are bent at the knees and hip joints, and in this position they are placed on a special stand. When examining the femoral neck, the feet are placed in a special holder, with the help of which the femur is rotated inward. If for some reason it is not possible to carry out densitometry of the entire spine or lumbar spine, then the bones of the forearm are measured to assess the condition of the skeletal system.

How are densitometry results interpreted?

Deciphering the results of densitometry is done by evaluating T and Z points

The decoding occurs as follows: the device is pre-loaded with the values ​​of all parameters for different parts of the body, they correlate with the indicators that the device’s sensor read from a specific person. As a result, the obtained data is analyzed and compared with the norm. The basic indicators to be assessed are:

1. BMC - bone mineral content (in grams);
2. BMD - bone mineral density (in grams/sq. cm.)

The examination results are assessed according to two bone density criteria - T score and Z score, the norm for each of them is different:

1. The first parameter - “T” - represents the ratio of the obtained data to the average normal value. The optimal values ​​of this criterion are digital data +2 to -0.9.
2. The second parameter - “Z” - determines the nature of bone density in accordance with the age and gender of the patient.

If the "T" values ​​are reduced and are within -1 to -2.5, then this indicates the beginning of the process of osteoporosis. Significantly low parameters - from -2.5 and below- indicate a more pronounced stage of the disease. If the “Z” scores are too low, additional examinations are usually prescribed.

Thus, osteoporosis affects the skeletal system (hip, humerus, etc.), so it is important to recognize it in a timely manner and begin its treatment. Depending on the results of the examination, appropriate treatment will be selected, which should stop the further development of the disease.

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Bone densitometry: what is it?

Densitometry is a research method for determining the mineral density of tissue. This method is the main way to diagnose osteoporosis.

Osteoporosis is a skeletal disease in which tissue density decreases and bone fragility increases. This disease often occurs due to age-related or hormonal changes.

Kinds

• KUDM - quantitative ultrasound densitometry
• DXA - dual-energy x-ray absorptiometry
• QMRI - quantitative magnetic resonance imaging
• QCT - quantitative computed tomography

Contraindications

• Pregnancy;
• Recent examination with x-ray or computed tomography, especially with the use of a contrast agent.

How is it carried out?

The patient takes a position on a special table. The sensor moves over a given area, and the image is projected on the computer screen.

You must remain still during the examination. Duration 10-30 minutes.

Preparing for the study

No special preparation required. The only thing you should do is stop taking calcium supplements the day before the procedure.

Decoding

The result of densitometry is two indicators: T-score and Z-score.

The T-score compares the patient's score to a standard. Norm: 1 point and above. A value from -1 to -2.5 indicates low mineral density, less than -2.5 means osteoporosis with a high risk of fractures.

The Z-score compares the obtained values ​​with the average values ​​of the patient's age group.

Densitometry (osteodensitometry, bone densitometry) is a diagnostic method used to determine the density of bone tissue.

Measurements can be carried out in two ways - using x-rays and ultrasound. The results obtained are processed by a computer program in accordance with age standards and gender.

Types of bone densitometry

X-ray - examination of skeletal bones with X-rays. The radiation exposure is minimal (400 times less than with conventional radiography). This method examines the bones of the lumbosacral spine and hip joint. These are the areas where fractures most often occur. You can also examine the bones of the shoulder, forearm, hip, or entire skeleton.

Ultrasound densitometry - the method is based on measuring the speed of ultrasound propagation through bone tissue. The higher the absorption rate, the denser the bone structure. This method is currently the only study that does not involve radiation exposure.

Indications

Which doctor prescribes densitometry and for what indications?

Osteodensitometry is the most informative method for diagnosing osteoporosis and is indicated for people over 50 years of age, because By this age, the calcium content in the bones is greatly reduced.

A referral for the procedure can be given by a rheumatologist or therapist.

Osteoporosis is a systemic disease characterized by a decrease in the density of the bone microstructure and increased fragility of skeletal bones, which leads to spontaneous fractures even with minor physical exertion or minimal trauma.

According to WHO (World Health Organization) statistics, osteoporosis ranks 3rd in mortality after cardiovascular and oncological pathologies. Women are more likely than men to be affected by the disease (4:1). But only 10% of patients know about their diagnosis because they have already had fractures (femoral neck, forearm bones or vertebral bodies).

Bone density measurement is necessary:

• people with 2 or more risk factors for osteoporosis:
  • early menopause in women (40-45 years);
  • underweight (women - up to 50-55 kg, men - up to 70 kg);
  • hereditary predisposition;
  • physical inactivity (sedentary lifestyle);
  • lack of calcium in the diet;
  • vitamin deficiency (lack of vitamin D in the body);
  • bad habits (alcohol abuse and smoking);
  • hormonal imbalance (endocrine diseases);
  • taking certain medications (corticosteroids).
• women in the postmenopausal period;
• patients with diabetes mellitus, renal failure;
• patients suffering from rheumatic diseases (rheumatism, arthritis, vasculitis, scleroderma, systemic lupus erythematosus, etc.);
• in cases of frequent bone fractures as a result of minor injuries.

Contraindications

Osteodensitometry is a safe, painless research method that makes it possible to carry out diagnostics repeatedly, and has virtually no contraindications, with the exception of the following cases:

• pregnancy (for x-ray method);
• other diagnostic procedures with contrast and radioisotope examination performed earlier than a week before the date of densitometry.

How is densitometry performed?

This procedure does not require special preparatory measures. However, the patient must meet several mandatory conditions:

• the day before the examination, stop taking medications containing calcium;
• notify the doctor if you have recently had a study with barium or other contrast agents, computed tomography or radiography;
• notify your doctor about your possible pregnancy.

The duration of the procedure is 10-30 minutes. The patient lies down on the densitometer diagnostic table, taking the required body position (depending on the area of ​​study).

With standard bone densitometry, 3 points are examined:

• neck of the femur;
• lumbar spine;
• radius.

The device's sensor will slowly move over the area under study, transmitting the image to the computer monitor. The radiologist can make a preliminary assessment of the patient’s bone tissue condition online. And upon completion of the procedure, the doctor gives a more detailed report.

Complications

There are no side effects or complications after bone densitometry.

To assess the dynamics of bone tissue condition, it is enough to undergo densitometry once every 2 years.

Decoding the results

The level of osteoporosis is determined by the T-score of minimum tissue density (MTD).

• T-criterion from +2.5 to -1.0 - normal;
• T-criterion from -1.0 to -2.5 - osteopenia (initial manifestations of osteoporosis);
• T-criterion below -2.5 - osteoporosis;
• A T-criterion below -2.5 (provided that the patient previously had 2 or more bone fractures) is a severe form of osteoporosis.

Alternative Methods

The ultrasound method is less informative, because This method examines only the heel and toe bones. The results of this study are considered preliminary and require X-ray confirmation.

Conventional x-rays can reveal changes in bone structure, but only when bone density has decreased by more than 30%. X-rays are usually prescribed to identify already developing complications of osteoporosis (fractures and cracks of bones).

Thus, X-ray densitometry is the most informative way to diagnose osteoporosis in the early stages of development.

Fluoroscopy, as a research method, became outdated in the last century. It has been replaced by new diagnostic methods. Densitometry began to be used for the structural study and diagnosis of bone tissue pathologies. This effective technique is indispensable for diseases that result in loosening of bone tissue. It allows you to identify the degree of loss of its density and detect the slightest structural anomalies.

Densitometry is not inconvenient, painless, safe and harmless. In addition, it does not take much time and does not require preliminary preparation. At the same time, the method is many times more effective than other instrumental methods, especially when working with the tissue structure of bones.

By the way. When diagnosing the spine, the procedure is performed most often in the lumbar area, as well as in the hip and shoulder joints. If there is such a need, densitometry of the complete skeleton can be performed.

The purpose of the study is to identify indicators of bone loss, decreased bone density, and impaired mineralization. An x-ray shows the same thing, but only in the case when the bone mass has decreased by a quarter, that is, its loss is 25% or more. With densitometry, a loss of even two percent can be seen. Of course, this is a very big breakthrough in diagnostics, because the earlier the disease is recognized and identified, the more effective the treatment will be.

Important! If similar diseases, which result in demineralization and loss of bone mass at the onset of the process, are diagnosed, it is possible to stop their development, increase mineralization and minimize the likelihood of fractures and bone damage.

Densitometry can be carried out either by X-ray or ultrasound, depending on the type of device used.

At the first stage of diagnosis, ultrasonic densitometers are often chosen. With their use, it is possible to detect osteoporosis at the zero stage with maximum safety for patients.

Ultrasound is an accurate and absolutely safe diagnostic method.

By the way. Ultrasound densitometry is not dangerous for both pregnant women and newborns. In addition, this method is cheaper than radiographic, and there is no need for a specially adapted and technically equipped room.

The indicator that determines the density of bone tissue is studied on the radius bones, which are found in the hand, as well as on the bones of the feet and tibia. The device measures the speed at which ultrasonic waves are transmitted through bone tissue. Then the readings are analyzed by the device, in comparison with the standard ones, and displayed on the monitor in the form of a graph. The diagnosis can be made immediately.

For indicators that deviate greatly from the norm, additional studies are required, which are carried out using an X-ray densitometer or a DXA machine (the method is called dual-energy absorptiometry - this is its abbreviation). This device carefully examines the shoulders, hips, spine and, if necessary, the entire skeleton.

Important! When examined with this device, the patient receives an incomparably lower dose of radiation than with a conventional X-ray machine. It is almost equal to the value of natural and non-hazardous radiological background.

The DXA densitometer allows you to study:

• mineral composition of bone tissue;
• its density and strength;
• bone elasticity;
• the size of the cortical layers;
• thickness of the structure.

In addition to initial diagnosis, both devices are used to monitor the treatment process in order to record changes in the composition of bone tissue. It is also recommended to undergo the study once every few years for preventive purposes for people who are at risk for possible bone diseases.

By the way. There is another option for densitometry called quantitative computer tomography. This is an improved CT scan (CT) that allows you to obtain a three-dimensional projection of bone structures. The method is effective, but gives the highest radiation load of all, so it is used infrequently and only in justified cases.

Examination of the spine with a densitometer lasts no more than ten minutes, and can be prescribed by a doctor if the patient experiences back pain, osteoporosis or related diseases.

How is the procedure

There is no preparation, no need to follow a diet or regimen the day before. The only caveat is that if you are constantly taking medications in which the main substance is calcium or its content is high, it must be interrupted a day before the procedure, since calcium can affect the bone structure, changing parameters.

It is advisable to wear loose clothing that does not have metal parts. The patient will also be asked to remove jewelry, watches, glasses, and other accessories. And if there is metal in the patient’s body (prosthesis, pacemaker, etc.), you need to warn the doctor.

Important! If shortly before the scheduled densitometry (five days or less) you had a computed tomography scan using contrast fluid, you must also inform your doctor about this before the study.

During the X-ray procedure, the patient is placed on a couch. Above it there is a sensor, which, having passed the desired zone, begins to read readings from the emitter placed under the patient’s bed.

The patient's legs are bent at the knees and placed on a stand. The body is fixed so that it is motionless. The back at the base should be pressed tightly to the plane. It is recommended to hold your breath even while passing the device so that the readings are as clear as possible. Most often the spine is examined at the level of segments L4, L5. Here the results will be most revealing.

Important! The procedure is contraindicated for pregnant and breastfeeding women. Also, you should not undergo it if radioisotope diagnostics were carried out two days before.

As for the ultrasound form of the study, it is carried out like a regular ultrasound, using a portable sensor using a gel. The information is transferred to a computer for processing.

How to understand the results

The densitometric apparatus already contains standards for the indicators and characteristics of human bones. They are different for each area of ​​the body, age, ethnicity of the patient and other factors taken into account. Based on these standards, analytical calculations are carried out by the device.

Main parameters:

• BMC, which measures mineral content (how many grams of minerals are in bone tissue);
• BMD, which shows the mineral density of tissue (in g/cm²).

Main analysis criteria:

Table. Criteria and their meaning

Criterion	What does it show	Meaning
T	How does the patient’s bone density compare with the density of a universal, absolutely healthy person of the same age and gender.	If the chart shows indicators in the range of +2... -0.9, this is the norm. When the result is from -1 to -2.5, the initial stage of osteopenia is diagnosed, which means that bone density begins to decrease. Below -2.5 – this is developing osteoporosis.
Z	How does this density indicator compare with the statistical average inherent in a group of people of the same age and gender?	Z-score indicators are more variable. If they go negative from zero and are too low, an additional study may be prescribed to clarify all the parameters.

For whom is densitometry indicated?

1. If there are two or more risk factors for osteoporosis.

   

2. Women during natural menopause.
3. Women with artificial menopause, which occurred after surgical removal of the ovaries.
4. Women taking hormonal contraceptives for a long time.

   

   Hormonal contraceptives, for example, the drug "Rigevidon", lead to a decrease in bone density with long-term use

5. Men over sixty years of age.
6. Patients who have undergone treatment with glucocorticoids, since they promote intensive removal of calcium from the body.
7. People of both sexes are over forty if they have had fractures due to falls, accidents, sports and work injuries, and so on.

   

8. In the presence of rheumatic or endocrine disease.
9. If a person is up to one and a half meters tall, while his parents are not short.
10. If a person's body weight is below normal.

    

11. When an x-ray taken for another reason revealed osteoporosis.
12. Age from thirty years, if there is a hereditary predisposition to osteoporosis.
13. If you have any of the spinal diseases: hernia, kyphosis, osteochondrosis, scoliosis.

    

14. Taking tranquilizers, diuretics, non-steroids and anticonvulsants for a long time.
15. Fragile asthenic physique.
16. Diets lasting several months.

    

17. Constant physical activity that is excessive.
18. When treatment control is required.
19. Bad habits such as excess alcohol, smoking, for a long time.

    

Advice. Today, densitometry can be done in almost any medical center and medical institution. This should be used, since early detection of bone mineralization disorders will prevent fractures.

What factors cause osteoporosis?

Why is osteoporosis dangerous and should be diagnosed as early as possible? This is a skeletal pathology that progresses and causes many complications. Bone mass decreases, tissue structure is disrupted, bones become fragile and break.

If you want to learn in more detail how, as well as consider the best remedies and treatment methods, you can read an article about this on our portal.

By the way. In this case, the disease develops gradually, almost asymptomatically. Height may decrease slightly (by 1-2 cm), the back may become rounded, and occasional aching pain in the back may occur, especially when walking for a long time or carrying heavy objects, as well as in a static position.

There is a list of factors that cause the disease or increase the risk of its development.

1. Lack of vitamin D.

   

2. Calcium deficiency due to insufficient intake.
3. Impaired calcium absorption if a person eats too much plant foods.

   

4. Lack of hormones that are involved in bone formation.
5. If there is an excess of phosphorus and salt, calcium is excreted in the urine.

   

6. With alcoholism, there is an accumulation of toxins in the body and loss of bone mass.
7. Decreased bone mass due to low physical activity.

   

8. Nicotine addiction.

If at least two factors from this list are present, regular densitometry is necessary. The ultrasound procedure is used more often for initial diagnosis because it is safer. There are no contraindications to it. The X-ray method is used specifically to clarify suspicions of osteoporosis or to monitor treatment.

If you want to know in more detail what it shows, and also consider the dangers of x-rays, indications and contraindications, you can read an article about this on our portal.

The following are considered contraindications:

Densitometry of the spine is today the most popular and most frequently used method for diagnosing osteoporosis, which helps determine the presence of not only the disease in development, but also at the initial stage, when treatment is still highly effective.

Video: Densitometry (measuring bone density)

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