Osteoporosis
Maria A. Fiatarone Singh, John Sutton Chair in Exercise, Nutrition, and the Older Woman, 2000
There are several common techniques for measuring bone density which are often identified by their abbreviation as listed in Table 2. All of these tests can effectively measure bone density at different sites in the body and can be used to predict total bone mineral content. Bone mineral density describes how tightly packed the bones are and therefore how “dense” they are. Bone mineral content is often referred to as bone mass and describes the total amount of bone in the body. The test that is used depends upon which tests are available as well as the expertise and preference of the radiologist overseeing the procedure. It is usual to measure the hip and spine bone density in addition to the total body bone mass, because these are the clinically relevant sites for osteoporotic fracture.
Thoracolumbar and sacral fractures
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Bone density studies are useful for evaluating the severity of osteoporosis and in advising patients of the likelihood of subsequent fractures. A T score of –2.5 indicates severe osteoporosis and warrants appropriate treatment as explained below. It is important to recognize that bone mineral density measured at the lumbar spine in those over 70 years of age may be falsely elevated due to end plate sclerosis, aortic calcification or spondyloarthropathy. In general, a low bone mineral density (T score <–1) is an independent predictor of fractures and hence it is recommended that all women aged 65 years or older, regardless of additional risk factors, have a bone mineral density measurement. A nuclear medicine bone scan is useful when surveying the entire skeleton for osteoporotic fractures, especially when symptoms are atypical. It is particularly helpful in diagnosing sacral insufficiency fractures, which are common in osteoporosis but difficult to visualize on radiographs. Bone scans also can differentiate between an acute or healed compression fracture because new fractures will appear as ‘hot’ spots.
Machine Learning in Radio Imaging
Punit Gupta, Dinesh Kumar Saini, Rohit Verma in Healthcare Solutions Using Machine Learning and Informatics, 2023
Dual-energy X-ray absorptiometry (DXA) images used to diagnose osteoporosis provide a T-score. A T-score value between +1 and −1 indicates healthy bone. A value between −1 and −2.5 shows that the bone has become prone to osteoporosis [2]. This state is called osteopenia. A value below 2.5 is an indication of the poor quality of a bone and a sign of osteoporosis. The decrease in bone mineral density (BMD) characteristic of osteoporosis increases the risk of bone fracture. In Europe, 30% of women over the age of 50 years suffer from osteoporosis [3]. According to a 2000 report, 3.1 to 3.7 million cases of osteoporosis were recorded, with a direct treatment cost of 32 billion dollars, a cost that could rise to 76.8 billion dollars per year in 2050 if this trend continues [4].
Application of ICF conceptual framework in Osteoporosis
Published in Physiotherapy Theory and Practice, 2020
Christina Ziebart, Allyson D. Page, Joy C MacDermid
The etiology of osteoporotic fractures is multifaceted, but it is related both to injury risk and the capacity of the bone to resist traumatic forces (Briggs et al., 2004; Lane, 2006). The risk of osteoporotic fractures increases as individuals’ age, as anticipated, since injury and fall risk both increase (Melton et al., 1989). The risk of fracturing can begin as early as 35 years of age (Melton et al., 1989), but it is more common at the onset of menopause in women (Melton et al., 1989). Osteoporotic fracture risk increases with lower bone mineral density (Genant et al., 1999). Fall-related fractures can occur in elderly adults (aged 75 years or older) due to multiple issues including: use of sedatives, impaired cognition, decreased strength, decreased proprioception, loss of balance, gait abnormalities, and foot problems (Tinetti, Speechley, and Ginter, 1988). However, some younger adults experience an osteoporotic fracture but are otherwise physically capable of maintaining daily activities, with minor precautions (Giangregorio et al., 2015, 2014; Papaioannou et al., 2010). Fracture prevention interventions and treatment may not be generalizable to all individuals with OP, and some individual tailoring of treatment may require consideration of the individual, his or her environment and personal factors, which could be addressed using The World Health Organization’s (WHO), International Classification of Functioning Disability and Health (ICF) conceptual framework as a guide.
Finite element analysis of fixation effect for femoral neck fracture under different fixation configurations
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Haipo Cui, Wenqing Wei, Yinlin Shao, Kewei Du
Oden et al. (1999) reported that the average load in the case of ITS fixation was higher than that in the case of positive triangle screw fixation; moreover, the former case yielded better tensile and compressive strain capacities, and there was no significant difference in torsional resistance between the two cases. Samsami et al. (2019) demonstrated that DHS fixation was a more effective approach than cannulated screws and proximal femoral locking plate techniques for vertical femoral neck fractures in young patients. Zhang et al. (2017) illustrated that, compared to using multiple cannulated screws, DHS fixation required larger skin incisions and more soft tissue dissection; however, it was associated with lower rates of fixation failure, reoperation, and overall rate of postoperative complications. Existing studies have reported on the FEA of femoral neck fracture fixation for many internal fixation configurations, but the effect of internal fixation for osteoporosis patients is rarely mentioned. It should be noted that bone mineral density can affect bone biomechanics (Zhuang et al. 2019). Femoral neck fracture is more likely to occur in the femoral model with osteoporosis or osteopenia; therefore, the selection of the internal fixation configurations in patients with osteoporosis is particularly important.
Irisin ameliorates bone loss in ovariectomized mice
Published in Climacteric, 2020
Y. Luo, Y. Ma, X. Qiao, R. Zeng, R. Cheng, Y. Nie, S. Li, R. A, X. Shen, M. Yang, C. C. Xu, L. Xu
Osteoporosis, a disease characterized by reduced bone density and quality, weakens the skeleton and increases the risk of fracture. The dynamic balance of osteoclast function and osteogenesis maintains the normal structure and strength of the bone. Osteoporosis triggered by menopause is the result of increased osteoclast function relative to osteogenesis in bone that culminates in bone density loss21. A clear link exists between physical activity and bone acquisition and maintenance; both mouse and rat models have collectively shown positive associations between exercise and increased bone size and bone mass22–24. The newly identified myokine irisin, produced by skeletal muscle in response to exercise, has recently drawn attention as a potential treatment for metabolic disorders3. In addition, approximately a dozen articles have reported that irisin promotes bone metabolism and increases cortical bone mass by promoting osteoblast proliferation and differentiation, as well as inhibiting osteoclast differentiation. Consistently, our present study showed a significant improvement in the bone mass and quality of OVX mice at 5 weeks after intraperitoneal injection of r-irisin.
Related Knowledge Centers
- Bone
- Bone Mineral
- Density
- Lumbar Vertebrae
- Osteoporosis
- Medical Imaging
- Radiology
- Nuclear Medicine
- Hospital
- Hip