Osteoporosis : Bone Disease : Tests & Treatment

Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone are altered.

Tests & Diagnostics

Bone mineral density testing (specifically a densitometry or DEXA scan) measures how much bone you have. Your health care provider uses this test to predict your risk for bone fractures in the future.
A special type of spine CT that can show loss of bone mineral density, quantitative computed tomography (QCT) may be used in rare

cases.
In severe cases, a spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of bones are not very accurate in predicting whether someone is likely to have osteoporosis.
You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.

Treatments

The goals of osteoporosis treatment are to:

1.Control pain from the disease
2.Slow down or stop bone loss
3.Prevent bone fractures with medicines that strengthen bone
4.Minimize the risk of falls that might cause fractures

There are several different treatments for osteoporosis, including lifestyle changes and a variety of medications.
5. Medications are used to strengthen bones when:
(a) Osteoporosis has been diagnosed by a bone density study.
(b) Osteopenia (thin bones, but not osteoporosis) has been diagnosed by a bone density study, if a bone fracture has occurred.
(c ) Bisphosphonates are the primary drugs used to both prevent and treat osteoporosis in postmenopausal women. Calcitonin is a medicine that slows the rate of bone loss and relieves bone pain. It comes as a nasal spray or injection.

6. Estrogens or hormone replacement therapy (HRT) is rarely used anymore to prevent osteoporosis, and are not approved to treat a woman who has already been diagnosed with the condition.

7. Teriparatide (Forteo) is approved for the treatment of postmenopausal women who have severe osteoporosis and are considered at high risk for fractures.

8. Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. Raloxifene is similar to the breast cancer drug tamoxifen. Raloxifene can reduce the risk of spinal fractures by almost 50%. The most serious side effect of raloxifene is a very small risk of blood clots in the leg veins (deep venous thrombosis) or in the lungs (pulmonary embolus).

9. There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebra from becoming fractured by strengthening the bones in your spinal column.
The procedure involves injecting a fast-hardening glue into the areas that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.)

10. Your response to treatment can be monitored with a series of bone mineral density measurements taken every 1 – 2 years. Women taking estrogen should have routine mammograms, pelvic exams, and Pap smears.

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