Obligatory medical device diagnostics.
- Osteodensitometry (bone densitometry) – for early diagnosis of osteoporosis and follow-up of therapy, bone density can be determined as follows:
- Dual X-ray absorptiometry (DXA, DEXA; dual X-ray absorptiometry; method of first choice).
- Quantitative computed tomography (QCT)
- Quantitative ultrasonography (QUS)
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Radiograph of the appropriate region – if fracture (broken bone)* is suspected; however, not suitable for measuring bone density (osteoporosis is not evident on radiograph until >30% of bone mass has been lost); the following signs may be present:
- Increased radiolucency
- Frame/fish/wedge vortex
- Fractures (e.g., compression and burst fractures).
- Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well suited for changes in the spinal cord as well as for imaging soft tissue injuries) of the spine (cervical spine/spinal cord/spinal cord MRI) – for evaluation of indirect fracture signs or soft tissues (the spinal cord and its sheaths, ligaments, intervertebral discs, and joints), respectively, including for evaluation of bone metastases, e.g., of a plasmocytoma (synonyms: Multiple myeloma, Kahler’s disease; plasma cell neoplasia/B-cell non-Hodgkin’s lymphoma).In addition to assessing the spinal cord and its sheaths (and thus detecting the risk of impending spinal cord damage from osseous structures), MRI best allows age determination of a compression fracture. With evidence of bone marrow edema, there is definite evidence of an acute or subacute vertebral body fracture (VC fracture)Note: Bone marrow edema can persist for months!
- Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation), particularly well suited for the depiction of bony injuries) of the spine (cervical spine/spine/spinal CT) – to specify the bone density as well as, if necessary. for the precise classification of a vertebral body fracture: e.g. decision whether a kyphoplasty (minimally invasive procedure for the treatment of vertebral fractures) for stabilization and pain relief in WK fracture should be performed or notThe CT thereby allows the reliable assessment of the bony conditions of the spinal canal.
* Femoral neck fracture (femoral neck fracture), distal radius fracture (fracture of the radius near the wrist), vertebral body fracture (vertebral body fracture).
Note!Only about one third of osteoporotic vertebral body fractures are diagnosed clinically! Therefore, radiological diagnosis is always required when an osteoporotic fracture is suspected.
Osteoporosis Screening
- The U.S. Preventive Services Task Force (USPSTF) advocates osteoporosis screening of women 65 years of age and older to prevent osteoporosis-related fractures (broken bones) (B recommendation).
