Densitometry: what is it when it is carried out and why it is important

Densitometry is a modern, non-invasive method of measuring bone density. The most commonly used method is DEXA (two-energy x-ray absorbium), which allows to accurately evaluate the mineral density of the bone. This is the main method for diagnosing  osteoporosis  and  osteopenia - conditions, when the bone strength is reduced and the risk of fractures is increased. 

DEXA technology provides continuous generation of a dual-energy spectrum of an X-ray beam, which produces a high-definition image.
The main research method for early diagnosis of osteoporosis is AP spine – scanning of the spine in the anterior-posterior projection.

1. High digital precision
2. Reliable geometric parameters of structures
3. Low dose pressure per patient
4. Possibility of using the method in pediatrics
5. Possibility of fastening patients with a large load (up to 204 kg)
6. Safety and comfort of the procedure
7. High speed of scan (up to 10 sec).

I. High risk:

• Female gender
• Caucasian or Asian type
• Age 65+
• Excessive thinness or overweight

II. Increased risk

• Smoking
• Excessive coffee consumption
• Alcohol
• Heredity
• Low calcium intake
• Sedentary lifestyle.

Densitometry is recommended if bone loss is suspected or if there are risk factors for osteoporosis. These may include:

menopause in women;

• Age over 65 (women) or 70 (men);
• Early menopause or surgical removal of the ovaries;
• Bone fractures after minor trauma;
• Rheumatoid arthritis and other chronic inflammatory diseases;
• Long-term use of certain medications.

What are the indications for densitometry?

The main indications are:

• Women after menopause, especially with other risk factors.
• People over 70 years old.
• Fractures after minor trauma.
• Detection of osteoporosis in first-degree relatives.
• Take medications that affect bone metabolism (glucocorticoids, aromatase inhibitors, antiepileptic drugs).
• Monitoring the effectiveness of osteoporosis treatment.

Are there any contraindications to densitometry?

There are no absolute contraindications. However, the study is not performed on pregnant women, even with a low dose of radiation due to the potential risk to the fetus. Also, restrictions may arise if it is impossible to lie still or if metal implants are found in the examination area (for example, in the hip joint).

Is densitometry safe?

Yes, this is an absolutely safe examination. The level of X-ray radiation during DXA scanning is very low - much lower than with diagnostic radiography, and does not pose a health risk.

How often can densitometry be performed?

In most cases, control densitometry should be performed every 1-2 months, depending on the presence of the disease and therapy. In the active treatment of osteoporosis - first of all, the effectiveness of the treatment should be noted. In the active treatment of osteoporosis - first of all, the effectiveness of the treatment should be assessed.

Some medications reduce bone density when taken over a long period of time. These include:

Glucocorticoids (prednisolone, dexamethasone) — inhibit bone formation.

Aromatase inhibitors (for breast cancer) — reduce estrogen levels.

Antiepileptic drugs (phenytoin, carbamazepine) — disrupt vitamin D metabolism.

Heparins, antidepressants (SSRIs), PPI (proton pump inhibitors) — can also have a negative effect on bone tissue when used over a long period of time.

If you are undergoing hormone therapy for breast cancer and are taking aromatase inhibitors (eg, letrozole, anastrozole, exemestane), it is very important to regularly monitor your bone health.

Why is this important?

Aromatase inhibitors reduce the level of estrogen in the body, which is necessary in cancer treatment, but at the same time, these drugs lead to bone loss. This can increase the risk of osteoporosis and fractures even without injury.

What to do?

Undergo a densitometry (DXA examination) - a simple and painless way to assess bone density.

Get your doctor's recommendations for the prevention or treatment of osteoporosis, if necessary.

Regularly monitor your bone health, usually once a year during therapy.

This is your safety and quality of life!

Thanks to timely examination, we can prevent complications and ensure the safest treatment.

To improve the accuracy of fracture risk assessment, the following can be additionally used:

• FRAX - 10-year fracture risk calculator (takes into account densitometry data + other factors).
• Laboratory tests - calcium, phosphorus, vitamin D, thyroid hormones.
• Vertebral morphometry - assessment of vertebral compression fractures.
• CT with density assessment (QCT) - in complex cases or with conflicting results.

Where to read more - evidence base

• National Osteoporosis Foundation (NOF, USA)
• American College of Rheumatology (ACR)
• Uptodate.com: Osteoporosis in postmenopausal women: Diagnosis and evaluation
• WHO Technical Report Series on Assessment of Osteoporosis

These resources contain reviews of the latest clinical studies and recommendations for the use of densitometry.

If you are concerned about the condition of your bones or you have risk factors - do not hesitate. Early diagnosis of osteoporosis helps to avoid serious complications. Contact us — we are always ready to help! To make an appointment for an examination, call  +38 044 521 30 03.