Godište 35 supplement 2 - Institut za reumatologiju

S U M M A R Y
Institute of Rheumatology
DIAGNOSIS OF OSTEOPOROSIS: CURRENT STATE IN EVIDENCE BASED MEDICINE
NADA PILIPOVIĆ
Osteoporosis constitutes a major health and social - economic problem through its association with
age-related fractures: the lifetime risk of any fracture occuring in women from the age of 50 years is
about 40% and in men in the same age is about 13%. Osteoporotic fractures are one of the most common
causes of dissability and they account for a high proportion of health care costs in many countries. The
most frequent sites for fractures are the vertebrae, hip and distal radius, with hip fractures being the most
serious. In fact, about 24% of patients die within the first year following a fracture of the hip.
Osteoporosis is silent disease and is often diagnosed after the first fracture has occured and the risk of
subsequent fractures increases with the number of previous fracture. Consequently, it is time to diganose
osteoporosis earlier and treat it as soon as possible in order to prevent subsequent fractures, improve the
quality of life of patients and reduce the costs involved.
Early diagnosis of osteoporosis is the responsibility of primary care. Bone density measurements targeted
at risk groups should be available for diagnosis.General, non-targetes screening is not indicated. Early
diagnosis of osteoporosis is possible only by measurement of bone density. The recommended methods
are based on low energy
x-ray radiation (DEXA). These can be used to measure bone density in vertebral bodies and the femoral
neck. Ultrasound measurement of the calcaneus is a new, rapid and non-radiating screening method. It is
not a density measurement and does not replace DEXA. Ultrasound measures also other factors and it
may have implications
in evaluating fracture risk. Radiography interpretation of mild osteoporosis is difficult and only the
probability of the condition can be evaluated. At present, no laboratory tests are available for diagnosing
primary osteoporosis.
K e y w o r d s: Osteoporosis, diagnosis, osteodensitometry