Densitometry is an x-ray examination aimed at assessing bone density. This simple method allows you to diagnose osteoporosis in the early stages, when it is still possible to select its effective treatment. Our Clinic performs asynchronous CT densitometry (QCT), which is the most reliable method for determining bone mineral density (BMD). According to the official position of the International Society for Clinical Densitometry (ISCD 2019), in accordance with WHO recommendations, T-scores calculated from two-dimensional views of the proximal femur when performing asynchronous CT densitometry QCT are equivalent to the corresponding T-scores of traditional dual-energy x-ray absorptiometry (DXA) when performing diagnosis of osteoporosis. CT densitometry (QCT) has the advantage of being able to measure volumetric mineral density of trabecular bone, which is more sensitive to the characteristics of bone tissue metabolism and less dependent on the presence of degenerative changes, body mass index, etc.
Indications for densitometry
For preventive purposes, densitometry is recommended annually for all persons at high risk of osteoporosis:
- postmenopausal women;
- men over 60 years old;
- patients with endocrine pathologies (diabetes mellitus, hyperparathyroidism), rheumatological diseases or a history of frequent fractures;
- people who are underweight or overweight.
To monitor the effectiveness of the treatment, the procedure should be repeated every 2 years.
Pros of research
Densitometry is not inconvenient, painless, safe and harmless. In addition, it does not take much time and does not require preliminary preparation. At the same time, the method is many times more effective than other instrumental methods, especially when working with the tissue structure of bones.
The procedure does not cause any inconvenience to the patient, the doctor immediately receives the results of the study
By the way. When diagnosing the spine, the procedure is performed most often in the lumbar area, as well as in the hip and shoulder joints. If there is such a need, densitometry of the complete skeleton can be performed.
The purpose of the study is to identify indicators of bone loss, decreased bone density, and impaired mineralization. An x-ray 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, a loss of even two percent can be seen. Of course, this is a very big breakthrough in diagnostics, because the earlier the disease is recognized and identified, the more effective the treatment will be.
Densitometry allows you to detect even minor changes in the bone tissue of the vertebrae
Important! If you diagnose osteoporosis and similar diseases that result in demineralization and loss of bone mass at the onset of the process, you can stop their development, increase mineralization and minimize the likelihood of fractures and bone damage.
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Densitometry can be carried out either by X-ray or ultrasound, depending on the type of device used.
Types of devices for densitometry
At the first stage of diagnosis, ultrasonic densitometers are often chosen. 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. Ultrasound densitometry is not dangerous for both pregnant women and newborns. In addition, this method is cheaper than radiographic, and there is no need for a specially adapted and technically equipped room.
The indicator that determines the density of bone tissue is studied on the radius bones, which are found in the hand, as well as on the bones of the feet and tibia. The device measures the speed at which ultrasonic waves are transmitted through bone tissue. Then the readings are analyzed by the device, in comparison with the standard ones, and displayed on the monitor in the form of a graph. The diagnosis can be made immediately.
The determining indicator of bone tissue density is detected during examination of the patient’s hands, feet and legs
For indicators that deviate greatly from the norm, additional studies are required, which are carried out using an X-ray densitometer or a DXA machine (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.
If necessary, the patient is prescribed densitometry of the whole body
Important! When examined with this device, the patient receives an incomparably lower dose of radiation than with a conventional X-ray machine. It is almost equal to the value of natural and non-hazardous radiological background.
The DXA densitometer allows you to study:
- mineral composition of bone tissue;
- its density and strength;
- bone elasticity;
- the size of the cortical layers;
- thickness of the structure.
Indicators of density and other parameters of bones
In addition to 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 the study once every few years for preventive purposes for people who are at risk for possible bone diseases.
Research results
Densitometry determines two parameters : T and Z. The first evaluates bone density in comparison with the indicators of a healthy young person, the second - in comparison with the average indicators of a person from the patient’s age group. An elevated Z-parameter and T greater than 2.5 correspond to osteoporosis. When the T-score is in the range from -1.0 to -2.5, we speak of osteopenia (a condition in which there is a moderate risk of fractures). The lumbar spine is assessed by measured bone density in g/cm3, compared to normal values.
The Spectra clinic offers CT densitometry (QCT) of standard examination areas (lumbar spine, proximal femur). The study is carried out using modern equipment, a GE Brivo CT 385 computed tomograph, which provides minimal radiation exposure. The duration of the procedure, including interpretation of the results, does not exceed 20 minutes. For your convenience, the radiology room is open daily.
Patients are recommended to be re-examined on the device that was used for their previous examination.
What is densitometry and how is the procedure performed?
What is osteoporosis
This is a disease in which some of the calcium is lost from the bones and they become brittle. Osteoporosis increases the risk of fractures. Everyone knows that this most often happens with age - in menopausal and postmenopausal women. But in fact, the risk group is much wider. A decrease in bone density at a young age (including in men) can be caused by:
- Bad habits (smoking, alcoholism),
- Lack of calcium and vitamin D,
- Rheumatoid arthritis,
- Diabetes mellitus type 2,
- Glucocorticoid drugs,
- Hormonal contraceptives,
- Diseases of the thyroid and gonads.
Bone tissues do not have nerve endings and are “silent” even when voids begin to form in them. Such fragility of bones is fraught with fractures, including those of the spine, as a result of very little physical activity. And fractures can take months to heal, since there is not enough calcium in the body to connect bone tissue.
That is why women over 45 years of age, as well as everyone who has at least one of the listed risk factors, should regularly undergo preventive examinations - densitometry.
Densitometry is the most accurate and one of the safest methods for diagnosing osteoporosis today.
When is densitometry necessary?
The doctor prescribes this type of study for the following symptoms:
- Frequent bone fractures, especially the femurs
- Fractures, dislocations associated with the vertebral region
- Regular back pain, the causes of which are unknown
- Diseases of the gastrointestinal tract, kidneys, liver
- Diabetes
There are also a number of diseases for which densitometry is recommended:
- Metabolic disorders associated with the removal of calcium and phosphorus from the body
- Neurological diseases
- Long-term hormonal treatment
- Previously diagnosed osteoporosis
- Endocrine system disorders
For preventive purposes, research is used in the following cases:
- monitoring the progress of osteoporosis treatment;
- preventive examination of the condition of bone tissue in people over forty years of age.
What contraindications exist?
There are not many of them, and they are related to the nature of the type of densitometry used.
- If the patient is pregnant, X-ray examination should not be used.
- Pain or disturbances in the lumbar region, due to which the patient will not be able to lie still for at least half an hour.
Dual-energy X-ray densitometry
The gold standard is dual-energy X-ray absorptiometry. It is the one that is used most often and gives the most accurate results.
This is very high accuracy, low level of radiation and quick results - the device not only measures bone density, but immediately correlates them with the norm and gives the deviation value.
Typically, during densitometry, not the entire body is examined, but only certain areas that are most susceptible to fractures (lumbar spine and femoral neck).
And the point is not only and not so much that such selectivity reduces the procedure time and allows for a reduction in radiation exposure.
With general densitometry, bone density indicators will always be normal (this is like measuring the average temperature in Russia). The fact is that different parts of the skeleton experience different degrees of stress throughout life, which affects the “quality” of bone tissue.
At the earliest stages of the disease, signs of osteoporosis are detected in the lumbar vertebrae L2-L4, and according to statistics, fractures with osteoporosis most often occur in the necks of the femurs. These are the optimal points for scanning.
Osteoporosis is completely curable. Treatment is medicinal. In case of endocrine system disorders, medications are prescribed to help restore hormonal levels. If there is a lack of calcium, it is recommended to take vitamin D. In general, the essence of treatment is to stop the process of leaching calcium from the bones and start the processes of bone tissue restoration.
Treatment for osteoporosis or osteopenia can take about five years, so it is important to carefully follow your doctor's instructions.
Bone densitometry
It is known that calcium reserves in the body begin to deplete starting at the age of 30. Therefore, it is important to diagnose osteoporosis as early as possible, especially for women. For these purposes, a new technique has been developed - bone densitometry. This research method allows you to quickly and accurately determine bone mineral density.
X-ray densitometry is the taking of photographs of the lumbar and thoracic spine in a lateral projection. In this case, bone density is calculated using special equipment based on the obtained images.
If the patient is overweight, densitometry of the distal forearm bones is performed.
Preparing for bone densitometry
No special preparation measures are required before the examination. The only requirement is not to take calcium supplements 24 hours before densitometry.
For convenience, you should follow these recommendations:
- Wear comfortable, loose clothing without metal fasteners, zippers or buttons.
- Remove jewelry and glasses.
- Warn your doctor about possible pregnancy.
How is X-ray bone densitometry performed?
Stationary examination systems consist of a table with a soft surface where a person is located (lying down), as well as a mobile “sleeve” that moves along the body and is located above the patient. Additionally, there is a shaped bracket into which the legs are placed when taking a picture of the hip joint.
An X-ray generator is built into the table, and a device for digital processing of the resulting images is built into the sleeve. After densitometry, they are displayed on the computer screen.
During the procedure, it is important to lie still and not move; sometimes specialists ask you to hold your breath for a short time to avoid blurring the picture.
The radiologist describes the results, providing estimates of bone calcium concentration and tissue density.
How does the procedure work?
There is no preparation, no need to follow a diet or regimen the day before. The only caveat is that if you are constantly taking medications 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, changing parameters.
The day before the procedure, you should stop taking calcium supplements, which may affect the results of the study.
It is advisable to wear loose clothing that does not have metal parts. The patient will also 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.
To undergo the procedure, you must remove all jewelry and accessories; if you have prosthetics or a pacemaker, be sure to notify your doctor about this.
Important! If shortly before your scheduled densitometry (five days or less) you had an MRI or computed tomography scan using contrast fluid, you must also inform your doctor about this before the study.
During the X-ray procedure, the patient is placed on a couch. Above it there is a sensor, which, having passed the desired zone, begins to read readings from the emitter placed under the patient’s bed.
The patient is positioned between the sensor and emitter
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 pressed tightly to the plane. It is recommended to hold your breath even while passing 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.
Most often, the spine is examined in the region of the 4th and 5th vertebrae, that is, in the lumbosacral region
Important! The procedure is contraindicated for pregnant and breastfeeding women. Also, you should not undergo 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 regular ultrasound, using a portable sensor using a gel. The information is transferred to a computer for processing.
From the portable sensor, all information is transferred to the computer
How to understand the results
The densitometric apparatus already contains 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 standards, analytical calculations are carried out by the device.
Data that is displayed on the monitor
Main parameters:
- BMC, which measures mineral content (how many grams of minerals are in bone tissue);
- BMD, which shows the mineral density of tissue (in g/cm²).
Main analysis criteria:
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The condition of the skeletal system largely depends on the density and structure of the bones. One of the diagnostic methods that allows us to identify changes in this tissue is densitometry. The examination is carried out using X-ray or ultrasound radiation. The procedure is painless and takes little time. Ultrasound densitometry is a screening (preliminary) method for determining bone density. Ultrasound densitometry requires absolutely no special preparation.
Ultrasound densitometry
In ultrasonic densitometry, bone density is measured using ultrasound beams. This method is used to determine general bone loss and for osteoporosis in the initial stage. The procedure is carried out using a portable densitometer, which measures the speed of passage of an ultrasound wave through bone tissue. The speed indicator is recorded using a special sensor, the data from which is sent to a computer where it is processed by the system. The computer displays the processed data on the monitor. Most of these devices are designed to assess the tissue of the calcaneus in women during menopause, since it is this part of the skeleton that is most susceptible to metabolic processes. The bone density in the femoral neck and heel in women is almost the same. This examination method is most often used when there are contraindications to x-ray methods. This study is approved for repeated use in pregnant women and nursing mothers.
The main advantages of ultrasound densitometry
- Quick diagnostics (no more than 15 minutes)
- Painless
- No toxic effects on the body
Ultrasound densitometry is used as a primary (preliminary) diagnosis of osteoporosis (screening method). If osteoporosis is detected, in order to make the most accurate diagnosis, experts recommend conducting a more specific study - x-ray densitometry.
Categories of patients who need to periodically (at least once every two years) undergo screening densitometry:
- Women during menopause, especially if it occurs early
- Women who have undergone surgery to remove the ovaries (adnexectomy)
- People with diseases of the parathyroid glands
- Women over 40 and men over 60
- People leading a sedentary lifestyle
- Persons over 30 years of age whose close relatives suffered from osteoporosis
- People who have had at least one bone fracture after a minor injury
- Patients taking medications for a long time that help wash out calcium salts from bone tissue (diuretics, hormonal contraceptives, anticoagulants, glucocorticoids, psychotropic, anticonvulsants, tranquilizers and others)
- People who follow various diets, adhere to vegetarianism, are fans of therapeutic fasting, eat irrationally and unbalanced
- Persons who regularly experience intense, exhausting physical activity
- People of short stature and low body weight
- Persons who abuse alcohol or smoke
Advantages of the ultrasonic densitometry method:
- Combination of high information content with absolute harmlessness to the body
- Simplicity and efficiency of the study - the duration of one study does not exceed 15 minutes
- Availability and relatively low cost compared to other research methods (MRI, CT)
- No special patient preparation required
- Completely painless
- It has no contraindications and can be used for pregnant and lactating women, for patients undergoing radiation therapy and radiographic examinations.
The method is suitable for screening studies to identify the risk of developing osteoporosis. The harmlessness of the method and the accessibility of such a study allows it to be completed without a doctor’s referral.
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Services and prices
Carrying out densitometry
1,400 rub.
Tatyana Vladimirovna Tararashkina Chief physician, obstetrician-gynecologist Work experience: 23 years
Tyan Oksana Aleksandrovna Head of department, obstetrician-gynecologist Doctor of the highest category Work experience: 25 years
Maksimova Tamara Anatolyevna Obstetrician-gynecologist Work experience: 6 years
Zabolotnova Olga Valentinovna Obstetrician-gynecologist Doctor of the first category Work experience: 25 years
Moiseeva Alla Vitalievna Obstetrician-gynecologist, ultrasound diagnostics doctor First category doctor Work experience: 36 years
Volkova Polina Dmitrievna Obstetrician-gynecologist, ultrasound diagnostics doctor Doctor of the highest category Work experience: 34 years
Postnikova Nadezhda Anatolyevna Obstetrician-gynecologist, ultrasound diagnostics doctor Work experience: 34 years
Shchelokova Elena Nikolaevna Obstetrician-gynecologist Doctor of the highest category Work experience: 37 years
Kapustina Irina Viktorovna Endocrinologist Doctor of the highest category Work experience: 32 years
Vdovina Nina Grigorievna Endocrinologist Doctor of the highest category Work experience: 50 years
Efremova Elena Georgievna Endocrinologist Doctor of the highest category Work experience: 47 years