PROGNOSTIC VALUE OF X-RAY DENSITOMETRY IN OSTEOPOROSIS

Abstract

Introduction of X-ray densitometry had revolutionized the diagnostics of osteoporosis. Majority of scientists believed that it was a diagnostic instrument close to almost ideal one capable evaluation of both: bone mineral density and likelihood of future fractures. Experiences accumulated during the previous years have slightly shaken this belief. It is more frequently heard that DEXA is not an ideal diagnostic instrument, but no better instrument has been created yet, which is also proved by our 12 years of experience. Materials and Methods. X-ray densitometry research evaluated 5200 patients aged 40-70. 4100 women and 1100 men. Medical History of 825 patients showed that they had bone fractures, 136 out of them were high energy ( pressure), the rest of them low trauma or no-trauma fractures. BMD index was low in 2736 patients (T score> -2.5). 48 patients had fractures in earlier lives registered in their medical records. Results. Low BMD index was identified in 2736 patients with osteoporosis only during the DXA lateral scans. It is arguable thatx-ray densitometry and BMD evaluation is the only criteria for the standards of diagnostics and the predictor of progressive bone loss and fractures. Discussion. While analyzing the results, diagnostic problems emerged at diagnostic process were taken into account, namely spine deformation, osteoporosis, osteochondrosis that camouflage real mineral density of the bones. At the same time, each patients with existing fractures in their record filled in special questionnaires describing clinical symptoms of the disease and risk-factors influencing the likelihood of the disease. Results of the work were processed through the analysis of variance (Fisher). Reliable correlation was not identified between DXA results and fracture risk index. This last one encourages routine use of FRAX in diagnostics of osteoporosis and prognosis of fractures before morphological evaluation of bones will be readily available to use as an additional diagnostic tool.