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Spinal densitometry. How is bone and spine densitometry performed? Densitometry how to prepare for the procedure

X-ray as a research method has become outdated in the last century. It was replaced by new diagnostic methods. Densitometry began to be used for structural research 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 does not cause inconvenience, painless, safe and harmless. In addition, it does not take much time and does not require preliminary preparation. At the same time, in terms of efficiency, the method surpasses other instrumental methods at times, especially when working with the tissue structure of bones.

By the way. The procedure is carried out when diagnosing the spine more often in the lumbar zone, as well as in the hip and shoulder joint. If necessary, full skeletal densitometry can be performed.

The purpose of the study is to identify indicators of bone loss, decrease in its density, impaired mineralization. The radiograph 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, you can notice a loss of even two percent. Of course, this is a very big breakthrough in diagnostics, because the sooner the disease is recognized and detected, the more effective the treatment will be.

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

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Densitometry can be performed both by X-ray and by ultrasound, depending on the type of apparatus used.

At the first stage of diagnostics, ultrasonic densitometers are more often selected. 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. The ultrasound type of densitometry is not dangerous for both pregnant women and newborns. In addition, this method is cheaper than X-ray, and there is no need for a specially adapted and technically equipped room.

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

With indicators that strongly deviate from the norm, additional studies are required, which are carried out using an X-ray densitometer or DXA apparatus (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 examining with this device, the patient receives an incomparably lower dose of radiation than with a conventional x-ray machine. It is practically equal to the value of natural and non-hazardous radiological background.

Densitometer DXA allows you to examine:

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

In addition to the 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 a study every few years as a preventive measure for people who are at risk for possible bone diseases.

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

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

How is the procedure

Preparation is not carried out, you do not need to follow a diet or regime the day before. The only caveat is that with the constant intake of drugs 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 by changing the indicators.

It is advisable to wear loose-fitting clothing with no metal parts. Also, the patient will 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 a contrast fluid, this should also be reported to the doctor before the study.

During the X-ray type procedure, the patient is placed on the couch. A sensor is located above it, which, passing through 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 firmly pressed to the plane. It is recommended to hold your breath even while passing through 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 lactating women. Also, you should not go through it if radioisotope diagnostics were carried out two days before.

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

How to understand the results

The densitometric apparatus has already laid down the 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 norms, analytical calculations are carried out by the device.

Main parameters:

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

Main criteria for analysis:

Table. Criteria and their meaning.

Criterion	What shows	Meaning
T	How does the patient's bone density compare with the density index of a universal, absolutely healthy person with the same age and gender.	If on the diagram the indicators are 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 decline. Below -2.5 is developing osteoporosis.
Z	How does this density indicator compare with the average, inherent in a group of people of the same age and gender.	Z-test scores are more variable. If they go negative from zero and are too low, an additional study clarifying all parameters may be prescribed.

Who needs densitometry

If there are two or more risk factors for osteoporosis.
Women during natural menopause.
Women with artificial menopause, which occurred after surgical removal of the ovaries.
Women taking contraceptive hormones for a long time.
Hormonal contraceptives, for example, the drug "Rigevidon", lead to a decrease in bone density with long-term use
Men over sixty.
Patients who have undergone a course of treatment with glucocorticoids, as they contribute to an intensive removal of calcium from the body.
People of both sexes over forty, if they had fractures due to falls, accidents, sports and work injuries, and so on.
In the presence of rheumatic disease or endocrine.
If a person is up to one and a half meters tall, while his parents are not short.
If a person's body weight is below normal.
When an x-ray taken for another reason showed osteoporosis.
Age from thirty years, if there is a hereditary predisposition to osteoporosis.
If there is any of the diseases of the spine: hernia, kyphosis, osteochondrosis, scoliosis.
Reception for a long time of tranquilizers, diuretics, non-steroids and anticonvulsants.
Fragile asthenic physique.
Diets lasting several months.
Constant physical activity that is excessive.
When control is required.
Bad habits such as excessive alcohol, smoking, for a long time.

Advice. Today, densitometry can be done in almost any medical center and medical facility. This should be used because 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. The bone mass decreases, the tissue structure is disturbed, the bones become brittle and break.

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

By the way. In this case, the disease develops gradually, almost asymptomatically. There may be a slight decrease in height (by 1-2 cm), a rounded back, episodic aching pain in the back, especially when walking for a long time or carrying heavy weights, as well as in a static position.

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

Lack of vitamin D.
Calcium deficiency due to inadequate intake.
Malabsorption of calcium if a person eats too much plant foods.
Lack of hormones that are involved in bone formation.
With an excess of phosphorus and salt - excretion of calcium in the urine.
With alcoholism - the accumulation of toxins in the body and loss of bone mass.
Decrease in bone mass due to low physical activity.
Nicotine addiction.

In the presence of at least two factors from this list, regular densitometry is necessary. An ultrasound procedure is used more frequently for primary 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 control treatment.

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

Contraindications are:

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

Video: Densitometry (measurement of bone density)

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What is densitometry? Densitometry is a modern method of instrumental diagnostics 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 performed to detect osteoporosis, a disease accompanied by a decrease in bone density and strength.

Such an examination is of great diagnostic value, since it allows timely identification and determination of the degree of damage to the human skeleton. Early diagnosis contributes to the timely start of treatment, which significantly reduces the risk of pathological development of the disease. Most often, densitometry of the lumbar spine, hip bones, and femoral neck is performed. In some cases, the entire skeleton is evaluated.

There are two main types of densitometry:

Ultrasonic densitometry. Used as a primary diagnostic. Ultrasound of the joints and bones does not have high-precision information content, but it has the highest safety and therefore can be used many times. However, it can be used to determine the degree of elasticity and stiffness of the bones, as well as to determine the density of the bone.
X-ray densitometry. The survey data are as accurate as possible. Since the duration of the procedure is insignificant, 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.

When is densitometry indicated?

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

The following are considered to be:

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

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

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

How is the diagnostic procedure going?

Diagnosis of osteoporosis is absolutely painless, does not injure and does not cause discomfort in the patient. No special preparation is required before the procedure. It is recommended to exclude foods rich in calcium (cottage cheese, cheese) from the diet a few days before the procedure and not to use medicines containing phosphorus and calcium salts inside. It is necessary to inform the doctor in advance about the available pacemakers and metal implants. It is important to keep the body still during the procedure. It is not necessary to free the body from clothing. 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 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 section, 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 which the thigh is rotated inward. If for some reason it is not possible to perform densitometry of the entire spine or the lumbar spine, then the bones of the forearm are measured to assess the state of the skeletal system.

How are densitometry results interpreted?

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

The decoding is as follows: the device contains the values of all parameters for different parts of the body, they are correlated with those indicators that were read by the sensor of the device from a particular person. As a result, the analysis and comparison of the obtained data with the norm is carried out. The basic indicators to be assessed are:

IUD - bone mineral content (in grams);
BMD - bone mineral density (in grams / square cm)

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

The first parameter - "T" - is the ratio of the received data to the average normal indicator. The optimal values of this criterion are digital data +2 to -0.9.
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” values are too low, as a rule, additional examinations are prescribed.

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

The study of the structure of bone tissue is required for various diseases of the musculoskeletal system, especially in old age. The study is especially important for women during menopause - a vulnerable period when the likelihood of fractures and injuries increases. You can prevent them in time by passing densitometry.

Densitometry - what is it?

Patients who are prescribed densitometry, what kind of procedure it is, how it is carried out - they can hardly imagine. This diagnostic method is non-invasive - it excludes penetration into the body. It is used to determine the concentration of calcium in bone tissue. At the same time, areas of the skeleton subject to pathological changes are examined. More often, the femoral neck and spine are the object of study - fractures and injuries of these areas are fraught with a complete loss of motor activity for a long time.

In medicine, several types of densitometry exist and are actively used (what it is - described above) (densitometry what it is). Depending on the goals and type of the survey area, the following is carried out:

ultrasonic densitometry;
quantitative computed tomography (QCT);
dual-energy X-ray absorptiometry (DRA);
quantitative magnetic resonance imaging (CMRI).

Densitometry - who does it?

Among the main goals pursued by densitometry, the diagnosis of osteoporosis is in the first place. This study allows you to identify the disease at the initial stage, to determine the presence of a predisposition to changes in bone tissue. Osteoporosis is treated by a rheumatologist. In most cases, he refers the patient for examination. However, other specialists can issue a referral for densitometry, suspecting a violation:

orthopedist;
gynecologist.

Indications for densitometry

Bone densitometry is indicated in the presence of changes in the musculoskeletal system, suspicion of osteoporosis. Given this, doctors consider it appropriate to conduct an examination as a preventive measure and for early diagnosis in the following groups of people:

patients with frequent fractures, a history of bone fractures;
women during the period, especially at its early onset;
patients with severe hormonal changes in the blood;
people leading a sedentary lifestyle;
after a long course;
patients with diseases of the endocrine system;
with excess body weight;
in the presence of constant pain in the lumbar region;
men over 60;
in the presence of burdened heredity.

Is densitometry dangerous?

Having found out what bone densitometry shows, what it is performed for, patients are worried about the safety of this procedure. According to experts, densitometry can be done without harm to the body. During the procedure, ultrasound is used, which does not affect the functioning of internal organs and systems. Even when densitometry is performed using X-rays, the exposure to the patient's body does not exceed that of fluorography. In practice, the most commonly used method is the use of ultrasound. Among its advantages:

quick results;
no radiation exposure;
the ability to control the quality of the therapy.

Densitometry - contraindications

The ultrasonic method of densitometry has no absolute contraindications. If necessary, it can be used even during pregnancy and lactation. As for the technique using x-rays, it is used in rare cases, with severe bone tissue disorders (spine, femoral neck).

X-ray densitometry (which is described below) is not performed in pregnant and lactating mothers, as well as in children. This method involves a long fixed stay of the patient's body in one position, which is contraindicated for persons with pronounced changes in the musculoskeletal system.

How often do densitometry?

Densitometry is a diagnostic study. It helps not only to identify violations in the structure of bone tissue, but also to determine their degree, localization, volume. In this regard, densitometry can be prescribed several times a year. In some cases, the study can be carried out monthly, in order to monitor the progression of existing bone lesions. The ultrasound method does not exert a load on the internal organs, so it can be used an unlimited number of times. The need for examination is determined individually by the doctor.

Densitometry - preparation for the examination

Patients referred for examination often ask doctors how to prepare for bone densitometry. Experts note that special preparation for the procedure is not required, however, in order to obtain objective results, a number of rules must be observed:

Stop taking calcium supplements at least 24 hours before your procedure.
You will be required to wear comfortable, loose-fitting clothing for the examination.
Metal locks, zippers should be absent.

In addition, be sure to tell your doctor if:

the day before, a barium examination was carried out;
CT was performed with the use of contrast agents;
pregnancy is suspected.

How is densitometry performed?

Long before bone densitometry is performed, doctors determine the area of study. The choice of methodology for the implementation of the procedure will directly depend on this. During the manipulation, the patient can change the position of the body several times at the request of the doctor. On average, the procedure takes 10-20 minutes. The result is indicated in the conclusion of the radiologist. The course of the procedure itself has its own characteristics and depends on the type of technique used - ultrasound or x-ray.

X-ray densitometry

Bone densitometry using an X-ray machine involves the use of stationary equipment. The patient is located on a special soft table, and the radiation generator is placed under it, the image processing device is on top. During the procedure, you must try not to move, otherwise you may get blurry pictures.

After the patient has taken the required position, a device passes over him, which transmits information to a computer. With the X-ray method, the following parts of the skeleton are examined:

lumbar spine;
proximal femur (Ward's triangle, greater trochanter, intertrochanteric region, upper diaphysis);
large segments of the skeleton - arms, legs, pelvis;
wrist joint.

Ultrasonic densitometry

Ultrasound densitometry is more widespread due to its safety. The procedure is carried out using a portable monoblock device, which eliminates the need for a specially equipped room, as is the case with X-rays. The part of the body to be examined (usually the heel, less often the finger or forearm area) is placed in a special recess on the device. Within 2-3 minutes, the device determines the speed of ultrasound through the structures of bone tissue. The computer processes the data and displays the results on the device monitor.

Computer densitometry

A computerized examination for osteoporosis - densitometry - is carried out in order to determine the density of the bone tissue of the spine. It helps to identify initial changes in the structure of the vertebrae, contributes to the early diagnosis of osteoporosis. Quantitative computed tomography, with which the study is carried out, helps to obtain a report on bone density in three projections.

Doctors manage to establish exactly the localization, the extent of the lesion. The obtained quantitative values of bone density are entered into a special formula. The result is a density equivalent. This densitometry (what it is described in the article) is performed with deep bone lesions.

Densitometry - interpretation of the results

Decoding of densitometry is carried out exclusively by a specialist. The results of the study display two indicators: T-score and Z-score. The first is calculated by comparing the patient's bone density with an established normal value. The results can be interpreted as follows:

norm - from +2.5 to -1;
osteopenia (decrease in bone mineralization) - from -1.5 to -2;
– -2.0 and below.

Bone densitometry is a modern non-invasive study of bones, which allows to determine their density and timely detect a severe developing disease - osteoporosis. This pathology leads to a decrease in the content of minerals (mostly calcium) in the bones, which causes an increase in the fragility of the skeleton. Osteoporosis is especially dangerous in the femoral neck and spine, where the most serious fractures can occur.

Densitometry - description

What it is - densitometry - should be known to all postmenopausal women, because it is in this period that the risk of developing osteoporosis is highest. This method of research in osteoporosis is the most effective and completely painless. It is included in the category of instrumental diagnostic methods and is designed to determine the density of bone tissue, or rather, to quantitatively and qualitatively assess the structure of bones.

Densitometry can be ultrasonic or X-ray, that is, it can be based on different principles of operation and is carried out on two types of equipment. The indicators are read by sensors, then transferred to the computer, and then the program calculates a number of indicators:

relative density.
The thickness of the cortical layer.
Architectonics (spatial structure), etc.

Densitometric equipment can be stationary, having a table and sleeves. Typically, such devices are used for x-ray densitometry in order to assess the condition of the spine and pelvic bones and joints. Also, the equipment is monoblock and is a small device for scanning the feet, hands and other individual bones and joints.

X-ray densitometry - what kind of method

X-ray bone densitometry is a research method based on the effect of X-rays - on their ability to pass through soft tissues and temporarily linger in dense bone tissue, in which a large amount of calcium salts and other minerals is concentrated. It is the rate of absorption of x-rays by the bones that makes it possible to calculate the degree of mineralization of different parts of the bone tissue.

The method is more accurate than ultrasonic bone densitometry.

For the procedure, a stationary table with a “sleeve” is used, where a person is placed for 10-30 minutes.

During the examination, the condition of the entire spine or its departments, the hip and wrist joints, or the entire skeleton is analyzed. Despite the accuracy, the technique is not suitable for everyone: for example, during pregnancy it is prohibited.

The price for x-ray densitometry is 1300-3000 rubles, depending on the type of clinic and the volume of bone tissue examined. Combined densitometry, including the use of a computed tomography scanner (CT densitometry), can cost even more (up to 5,000 rubles).

Ultrasonic densitometry and its features

The characteristic of ultrasonic densitometry converges with that described above according to the data obtained and their interpretation, although the accuracy of the method is lower. In general, densitometry on ultrasound equipment is a way to indirectly determine bone density. When an ultrasonic wave passes through bone tissue, its speed will vary in areas with different densities. Ultrasonic waves of a certain frequency, after passing through the bones, will be recorded by the sensor, and after processing they will appear before the specialist in the form of the necessary data.

The price for this type of examination is 700-2000 rubles.

The method, despite the lower quality of information, is used very often due to its complete safety, speed and the ability to perform without referrals and additional examinations.

This type of densitometry is allowed for pregnant and lactating women and lasts 5-15 minutes.

Indications for densitometry

The main indication for this kind of diagnosis is a suspicion of osteoporosis and a preventive examination for this disease. The procedure will help identify:

The amount of minerals in bone tissue in absolutely any part of the body or in the entire skeleton.
General condition of the spinal column.
The presence and degree of osteoporosis or osteopenia (a slight decrease in calcium in the bones).
Fractures of bones and vertebrae.

Thus, densitometry is indicated for everyone who is at risk of developing osteoporosis - a decrease in bone density, especially people who are exposed to certain risk factors. Densitometry is recommended for such problems and conditions:

Metabolic failures, metabolic diseases.
Pregnancy, especially multiple pregnancies.
Diseases of the spine - osteochondrosis, spondylolisthesis, injuries and fractures.
Endocrine diseases - hypothyroidism, parathyroid pathology, diabetes.
Long-term treatment with hormones and other calcium-releasing drugs.
Some neurological pathologies.
Recurring fractures.
Rheumatism.
Malnutrition, frequent strict diets.
Alcohol abuse, smoking, low body weight.

The technique will help to predict the risk of hip fracture for 10 years, as well as to evaluate the effectiveness of the treatment. For children, densitometry can be recommended to analyze the adequacy of providing the body with calcium and phosphorus during intensive bone growth.

Since the amount of calcium begins to slowly fall after 30 years, then from about 40 years of age, densitometry should be performed every 2 years. It is screening examinations that will help identify osteoporosis at an early stage and cure it. In the same mode, it is worth doing an examination for women after 30 years old, whose close relatives suffer from osteoporosis. Men are recommended preventive examinations after 60 years.

How to prepare for a bone densitometry procedure

Preparation for densitometry is simple, but includes a number of recommendations:

For a day, do not drink drugs containing calcium, phosphorus.
For a day, do not eat foods rich in calcium - cottage cheese, cheese.
Do not perform an MRI or CT scan with contrast, as well as an isotope scan, one week before the densitometry.
Do not wear clothes with metal elements (with rivets, zippers, buttons) during the examination so that the information content of the results is not reduced.

Immediately before the procedure, you should remove the watch, put your mobile phone in your bag.

Carrying out a densitometry examination

If densitometry is performed on x-ray equipment, then the patient is placed on the table available in the stationary device, after which the specialist leaves the room. When examining the spine, the legs are supported with a special stand.

If the pelvic bones are examined, then the legs are placed in a curly brace. Next, the sleeve of the device moves and takes a series of pictures, and the data is fed into the computer. It is impossible to move during the diagnosis, only if the doctor does not ask for it. Also, sometimes you may have to hold your breath.

How is ultrasound densitometry performed? In this case, the patient lies on a regular couch, and the doctor performs an ultrasound procedure with a special nozzle with a sensor. Both types of research do not cause any pain, they are performed quickly enough.

There are no contraindications to ultrasound densitometry, the procedure can be performed according to indications to any person. X-ray diagnostics is strictly prohibited for pregnant women, and is also not recommended during lactation and is not done without urgent need for children.

Deciphering the results of densitometry

The most important indicators when deciphering the results are as follows:

Bone density (“T” indicator), which is compared with the norm in young people by points. The normal value is 1 point and above, -1-2.5 - osteopenia, less than -2.5 - osteoporosis.
Bone density in comparison with the norm in the age group (score "Z"). This indicator should be within certain age limits.

Diseases for which densitometry is prescribed:

Osteoporosis
Osteopenia
bone fractures
Spinal fractures

Densitometry, both X-ray and ultrasound, is designed for early detection of the insidious disease - osteoporosis. The method is very sensitive, so it is worth performing it regularly in order not to give the pathology a chance for development and progression.

One of the most reliable diagnostic methods - a disease accompanied by a decrease in bone mineral density - as well as a method that allows you to assess the quality, is densitometry. We will talk about what kind of study this is, what categories of patients it is indicated for and what is contraindicated, as well as about the types of densitometry and the method of its implementation in this article.

What is densitometry and what are its types

Densitometry is a non-invasive method for the quantitative determination of bone mineral density. This study is carried out in specialized public and private medical and diagnostic centers. The procedure is absolutely painless for the patient and does not require anesthesia.

There are 2 types of densitometry: ultrasonic and x-ray.

Ultrasonic densitometry

It is a non-radiological diagnostic method. Approved for repeated use in pregnant women and nursing mothers. It is carried out using a portable densitometer, which measures the speed of passage of an ultrasonic wave through the bone tissue. The speed indicator is recorded using a special sensor, the data from which is sent to the computer, where it is processed by the system, and then displayed on the monitor. Object of study: most often, the calcaneus.

The advantages of ultrasonic densitometry are the speed of the diagnostic procedure (as a rule, the time spent on it does not exceed 15 minutes), painlessness, and the absence of toxic effects on the patient's body. In addition, this study is financially available to most patients.

It is used, as a rule, as a primary diagnosis of osteoporosis, but if it is detected, in order to make the most accurate diagnosis, it is recommended to conduct a more specific study: X-ray densitometry.

X-ray densitometry

A more accurate research method than ultrasonic densitometry. Its essence lies in determining the degree of attenuation of X-rays when they pass through the thickness of the bone tissue. This indicator is estimated using a special apparatus. The latter then, following the algorithm, calculates the amount of mineral substances that the X-ray beam passing through the bone met on its way.

The object of study during X-ray densitometry can be the lumbar spine, the wrist joint, the femur, especially its upper section, the entire skeleton or its individual parts.

Since this type of densitometry involves a certain dose (albeit a minimal one) of X-ray radiation, which is known to have a toxic effect on the human body, it is not recommended to conduct it repeatedly over a short period of time. For the same reason, it is contraindicated in certain categories of patients, in particular pregnant women and women who are breastfeeding babies. In addition, this type of densitometry requires very expensive equipment, which is allowed to be placed only in rooms specially designed for this study. All this makes X-ray densitometry inaccessible for the majority of patients as a diagnostic method.

Who needs densitometry

This study must be periodically (at least once every 2 years, on the recommendation of a doctor - and more often) to undergo the following categories of patients:

women during the period, especially in the case of its early onset;
women over 40 and men over 60;
women who have undergone adnexectomy (that is, those who have had their ovaries removed);
persons suffering from diseases of the parathyroid glands;
persons who have had at least one bone fracture due to minor trauma;
persons over the age of 30 years, whose close relatives suffered from osteoporosis;
persons taking long-term medications that promote the leaching of calcium salts from bone tissue (anticoagulants, oral hormonal contraceptives, diuretics, psychotropic, anticonvulsants, tranquilizers, and others);
people who abuse and smoke;
persons suffering (leading a sedentary lifestyle);
people of short stature with low body weight;
people who follow various diets, who are fans of the fasting system;
persons who regularly experience intense, exhausting physical activity.

To whom densitometry is contraindicated

Ultrasonic densitometry is a safe study, which has no contraindications. X-ray method is not recommended during pregnancy and lactation.

How to prepare for densitometry

Special preparation for the study is not required.

If the purpose of the study is the primary diagnosis of osteoporosis, you should not take calcium supplements or other drugs that increase the content of calcium in the blood before the study.

There is no special preparation for densitometry. The patient's clothing should be comfortable, without zippers or metal buttons. If there are any metal jewelry, they must be removed before the examination.

If a woman who is scheduled for densitometry is pregnant, she should definitely notify her doctor about this.

How is the study going

Ultrasonic densitometry is carried out using a portable monoblock device. The part of the body being examined - more often the heel, less often the finger or forearm - is placed in a special niche located on the device. Within a short period of time - usually 2-3 minutes - the device determines the speed of ultrasound through the bone structures and processes the results, after which it displays them on the monitor of a computer connected to it.

X-ray densitometry is carried out using stationary equipment. The patient lies on a special padded table, with the X-ray generator placed underneath and the image processing unit on top. During the study, you can not move - to reduce the risk of blurring the picture, the doctor asks the patient to hold his breath for a while. When the patient is positioned in the desired position, the "sleeve" with the reader smoothly passes over him, at this time the device generates an image and sends it to the computer.

How to decipher the result of densitometry

In fact, the diagnosis of "osteoporosis" is made on the basis of an assessment of 2 indicators obtained as a result of densitometry - these are T- and Z-criteria.

T-criterion is obtained by comparing the obtained values of the bone density of the subject with the average normal bone density of women aged 30-35 years.

The Z-score is obtained by comparing the bone density of the examined person with the average normal value of the bone density of his age group.

The unit of measure for bone density is SD.

Values of norm and pathology:

T-criterion is normal - from +2.5 to -1;
With osteopenia - from -1.5 to -2;
With osteoporosis - from -2.0 and below;
In severe osteoporosis - less than -2.5 in combination with at least one bone fracture due to minor trauma.

As for the Z-criterion, if its value is too high or too low, this is an indication for additional examinations.

Thus, ultrasound or X-ray densitometry are diagnostic methods that allow you to determine the degree of bone mineral density. This is necessary in order to promptly diagnose the patient with osteoporosis, thereby preventing its formidable complications. Because this study is relatively new, it is not yet universally available - you should check with your healthcare provider about the nearest osteoporosis diagnostic center.

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