Where can densitometry be done? Review of the best diagnostic centers. Densitometry Ultrasonic foot densitometry

Bone densitometry is a research method that evaluates the structure, density of bone tissue. The procedure is designed to determine the degree of osteoporosis and monitor the effectiveness of therapy. The study provides a quantitative characterization of the calcium content in the bone, which makes it possible to identify pathology at the asymptomatic stage.

Among the methods of examining bones for the presence of osteoporosis, densitometry is the most reliable study. The technique is classified as non-invasive, that is, during the procedure, the integrity of the skin and deep structures is preserved.

Bone contains a large number of organic and inorganic compounds. The main mineral it contains is calcium. Its quantity determines bone density. The diagnosis of osteoporosis is based on the study of this parameter.

There are several types of osteodensitometry:

• X-ray densitometry;
• photon absorptiometry;
• computer and magnetic resonance densitometry;
• ultrasound densitometry (echoosteometry).

X-ray densitometry can be done in two ways:

1. Dual-energy osteodensitometry is a study that measures the absorption of an X-ray by bone tissue (the denser the bone, the worse the absorption).
2. Peripheral densitometry works on the same principle as dual energy, but the radiation dose is much lower. The method is designed to study the condition of the bones of the extremities.

The essence of photon absorptiometry consists in measuring bone density, assessing the absorption of radioisotopes. The method allows you to determine the degree of bone loss.

CT and MRI are the most accurate and reliable techniques. With their help, differential diagnosis is made between other bone pathologies. The main disadvantage of these methods is their high cost, so they are not as widespread as X-ray and ultrasound.

Ultrasound densitometry is inferior in accuracy to other studies, but it is a simple, fast, safe technique. Density is measured by reflecting an ultrasonic wave off the bone. Ultrasound allows you to visually determine its elasticity, stiffness, density.

Watch the video of the MRI of the knee:

Indications and contraindications

Densitometry is done to diagnose and analyze the therapy of osteoporosis, how often? If there is an identified diagnosis, control is performed once a year. For this can be used: X-ray, magnetic resonance or computer densitometry.

If more frequent monitoring is needed, then it is better to resort to bone ultrasound. This method allows one to simultaneously examine the state of both the peripheral (forearm, heel bone) and the axial skeleton (spine).

If a person does not have an established diagnosis, then densitometry is performed in the presence of risk factors or suspicion of osteoporosis.

The main indications for the study:

• mature age;
• pathologies of the musculoskeletal system: scoliosis, osteochondrosis, intervertebral hernias, compression fractures, subluxation of the vertebrae;
• electrolyte metabolism disorders;
• taking medications that have an effect on the metabolism of calcium and phosphorus (hormonal, antipsychotic, anticoagulants, diuretics);
• endocrine and systemic diseases;
• diseases of the parathyroid gland;
• the presence of pathological fractures;
• women during menopause or after removal of the ovaries;
• in the presence of oncology.

Frequent densitometry is permissible only when using ultrasound. Radiographic densitometry has a number of contraindications:

• pregnancy or lactation;
• severe condition or decompensation of chronic diseases;
• pathology of the thyroid gland;
• the presence of radiation sickness.

The main peak in the incidence of osteoporosis occurs at the age of 50–75 years. In women, the first signs are observed in the menopausal, postmenopausal period (from 45 to 55 years). This is due to a decrease in estrogen synthesis due to inhibition of ovarian activity. Therefore, similar symptoms also occur with castration syndrome (occurs after total oophorectomy).

Also, signs of bone loss can occur during pregnancy. This is due to increased calcium consumption or inadequate replacement of the deficiency. It must be remembered that X-rays are contraindicated during pregnancy. In this case, the diagnosis is carried out using echoosteometry (ultrasound bone densitometry).

In men, the first signs of osteoporosis are detected after the age of 50. The onset of the disease is associated with hormonal changes, a decrease in the work of the parathyroid glands.

Young people with idiopathic forms of osteoporosis require special attention. Most often, such pathologies are noted in close relatives. Therefore, in the presence of hereditary factors, it is necessary to carry out diagnostics starting at the age of 30–35.

How to properly prepare for densitometry

Ultrasound bone densitometry does not require special training. The study can be carried out at any time and serve as a method of express diagnostics.

When conducting computer, magnetic resonance or X-ray osteodensitometry, it is necessary to stop taking medications that affect the level of calcium in the blood 2 weeks before the study. In addition, you should not eat large amounts of foods containing calcium (cottage cheese, milk, fish, spinach, cheese).

Also, the subject must have information about his passport and anthropometric data (height, weight). The doctor enters these parameters into the memory of the osteodensitometer. Subsequently, a computer analysis of the survey results is carried out.

Survey

Ultrasound densitometry allows you to examine all areas of suspected osteoporosis. Patient data and ultrasound results are recorded with a bone densitometer.

In the absence of obvious foci, bone densitometry is performed starting from the calcaneus. Then other parts of the limbs, as well as the axial skeleton, can be examined. The duration of the procedure does not exceed 20 minutes.

When performing X-ray densitometry, remove metal or jewelry. If you have splints or dentures, notify your doctor. The main condition for qualitative research is to maintain complete immobility. Even a slight movement can lead to misinterpretation of results and misdiagnosis.

The examinee assumes a position in which the visualization of the pathological focus will be the most detailed. Then the doctor takes several pictures, after which a computer analysis of the data is performed.

The specialist tells about the ultrasound examination of the spine in the video:

Decoding of research results

Normally, when analyzing a graphic image, the bone has an almost uniform structure, white color. All anatomical landmarks are preserved. When foci of disorganization occur, one can see enlightenment in separate parts, structural disturbances, pathological fractures.

The severity of manifestations depends on the stage of the disease. At the onset of the disease, only a change in the bone pattern can be seen (dark foci - an increase in tissue transparency). In the terminal stages, there are violations of the structure of the bone - usurs ("eaten" contours), pathological damage to the skeleton (compression fractures of the vertebrae, calcaneus, femoral neck).

In the process of research, two main parameters are measured and analyzed:

• BMC - bone mineral content (in grams);
• BMD - bone mineral density (grams / square cm).

The parameters are assessed according to the basic criteria of bone density:

• "T" score - the ratio of the patient's data to the average indicator. Normally, the value ranges from +2 to -0.9.
• "Z" score is a more objective parameter. It shows the correspondence between patient data and normal values ​​in a particular sex and age group.

At the beginning of the pathological process, the "T" criterion is in the range from -1 to -2.5. A reading below -2.5 indicates disease progression and requires urgent correction.

How much does the procedure cost?

The cost of the service depends on the method of implementation and the scope of the study. Ultrasound bone densitometry is the most cost effective procedure. The cost of the research does not exceed 2,000 rubles. Computed and magnetic resonance osteodensitometry are expensive. The cost of the procedures reaches 9,000 rubles.

When examining individual areas, examinations of the spinal column are also expensive. The average cost is 4000 rubles.

Region	Average cost (in rubles)
Moscow	2000–9000
Saint Petersburg	1500–9000
Novosibirsk	1500–6000
Kazan	1600–6200
Yekaterinburg	1500–4700

Osteoporosis remains a severe disabling disease. The lack of timely treatment is fraught with a complete loss of the ability to move. Medicine is capable of stopping degenerative processes or even causing regression. The main problem in this case is the lack of early diagnosis.

Bone densitometry is a simple, accurate and convenient method for detecting osteoporosis and monitoring treatment. A large number of methods allows you to choose a study that will be safe and informative for a particular person.

If you have experience in bone densitometry, tell us about it in the comments. Be healthy.

Over the years, bone tissue loses calcium, osteoporosis develops. Densitometry is an X-ray test that provides doctors with information about changes in bone density.

If osteoporosis is suspected or there are factors of its possible development, doctors prescribe densitometry every 2 years. This approach gives doctors the opportunity to see the development of osteoporosis in the early stages, start timely treatment, and prevent fractures.

Densitometry is an examination that determines the mineral composition of bone tissue, the presence of calcium compounds. In traumatology, the peripheral parts of the fracture sites are often examined, however, according to the data obtained, doctors see a clinical picture of the general condition of bones throughout the body.

Elderly people suffer from complications after fractures due to the slow healing of bone fragments. Therefore, early diagnosis using densitometry is important. It helps prevent the formation of osteoporosis.

Indications for research

Osteoporosis develops in people of all ages, not just the elderly. Conditions that reduce blood calcium levels are manifold. But they all affect bone density and strength.

The indications for the study are:

• dysfunction of the parathyroid gland and pathology of its development; with hypoparathyroidism, the activity of the gland decreases, the synthesis of secretion - parathyroid hormone, which is responsible for obtaining calcium by bone tissues, decreases its excretion by the renal system;
• injuries accompanied by bone fractures;
• constant treatment with drugs that have the ability to lower the calcium content; these include steroid-type hormones, oral contraceptives, diuretics - Furosemide, Torasemide, anti-seizure drugs - Phenobarbital, Carbamazepine;
• the use of alcoholic beverages at the stage of alcohol dependence disease;
• women over 40; men over 60;
• patients over 30 when family members have been diagnosed with osteoporotic disease;
• people who move a little;
• women on diets to lose weight;
• patients working in production with high physical exertion;
• dynamic monitoring of the patient during treatment, to assess the effectiveness of the chosen direction of therapy.

Densitometry for a woman is an important examination. Women are at risk of calcium loss due to fluctuations in the production of the female hormone - estrogen, so there is an additional list of prescriptions for such a procedure for them.

These are the situations:

• the period of menopause (it is important to check the condition of the bones at its early onset, before the age of 45);
• after operations of adnexectomy, extirpation of the uterus.

Densitometry is an examination that gives the doctor the necessary information about the condition of the patient's bone tissue.

Contraindications and restrictions

Densitometry is such a gentle examination, to which there are practically no contraindications. But the use of X-rays still has contraindications.

Research on installations with X-ray radiation examinations are not carried out:

Densitometry is such a serious examination during which a woman and a growing fetus may receive unwanted radiation. Therefore, an absolute contraindication for examination with X-ray radiation is given to pregnant women.

Research equipment

Medical devices for examining bone tissue are represented by two devices:

• Ultrasound densitometers using ultrasonic irradiation;
• X-ray densitometers with X-ray irradiation.

Pluses of ultrasonic devices:

• safe examination;
• quick examination;
• compact and mobile devices;
• there is computer support with special programs;
• the survey is possible in any room;
• democratic cost of the device.

The ultrasound densitometer does not provide the most accurate information.

Frequently used models of ultrasound densitometers:

• Sonost 3000 device, made in Korea: equipped with a monitor and a thermal printer, an interface based on the latest Windows models;
• McCue CUBA Clinical apparatus, made in the USA: it has a high accuracy of examination, it can be connected to a computer with a printer if there is a special program;
• Israeli-made Omnisense 7000 device: equipped with a screen, a main unit, probes for examining various bones.

Advantages of X-ray densitometers:

• high-precision measurement;
• direct examination of the hip joints;
• examination of the lower back, the most accurate method for determining the presence of osteoporosis;
• examination of large sections of the bones.

Cons of devices:

• patients receive x-rays;
• a special room is required to install the device;
• expensive price of an X-ray densitometer.

The most popular models of X-ray devices:

• Norland ELITE installation, manufactured by Norland Medical Systems: the largest device in the world, equipped with modern software;
• Norland XR46 rig, production of the same company: gives accurate measurements with calibration of the mass of different tissues, there is a positioning system with a rotation angle;
• installing LUNAR iDXA: equipped with a program for examining children, studying the body index, analyzing the state of bone tissue;
• DEXXUM 3 device produced by the South Korean company OsteoSys conducts a study using the method of dual energy absorptiometry, an important advantage is the software in Russian.

X-ray and ultrasound densitometers of various production are successfully used in large diagnostic centers, medical departments at large industrial enterprises. Their choice and the range of prices allows a medical institution to obtain such a device that will suit the needs of an enterprise, city, region.

Types of densitometry

The study is carried out with special devices - densitometers.

They differ in the method of obtaining results:

The latter methods are rarely carried out due to their high cost.

Ultrasonic densitometry

Ultrasound densitometry is a study of the mineralization of bone tissue, which is performed by the method of indirect passage of radiation. Ultrasound - the wave travels through the bone tissue with different density, at different speeds.

The device transmits ultrasound at a certain frequency through the bone of a given area, the examination indicators are captured by the output sensor.

Data with low information content is obtained, however, the device is used often. This is due to the safety and speed of research.

X-ray densitometry. CT densitometry

The method of rays of the X-ray machine examines the areas of the bone indicated by the doctors, the available program calculates the level of bone mineralization.

Today, various methods of X-ray densitometry have been developed and are used:

• dual energy; the technique is based on the passage of two X-ray beams - the first goes along the bones, the second - along the soft tissues; then the indicators of their promotion are compared; the analysis is carried out according to the general principle - if the mineralization of bones is high, then the permeability of the rays is low; this method usually examines the spine and thigh bones;
• peripheral densitometry; the same measurement principle is used, but the patient receives a lower dose of radiation; this method evaluates the parameters of bone tissue, and is also used to monitor treatment.

CT densitometry also uses exposure to ionizing radiation. CT scan gives a picture of the bones in volume. It is rarely used because of the high ionizing radiation and the high cost of the examination.

The indications for CT examination are:

• long-term intake of hormones;
• lingering inflammation in the digestive tract;
• cystic fibrosis of a pulmonary-intestinal nature;
• connective tissue diseases;
• dysfunction of the lungs and kidneys;
• dysfunction in the gonads, lack of production of sex hormones;
• genetic diseases of the musculoskeletal system.

Bone densitometry, performed by CT, gives doctors indicators of a decrease in bone volume at the very beginning of the development of pathology. This is a good technique for early diagnosis of the disease.

Alternative diagnostic methods

• photon absorptiometry where the survey is carried out with photon beams; they pass through the bone tissue, and the calculation of mineralization is carried out by the absorption of photons during their passage through the tissues; low exposure is applicable here;
• X-ray computed tomography - RKT.

There are 2 photon-type absorptiometry:

• monochrome; used to study mineralization in peripheral bones;
• dichromic; used to obtain data on the mineralization of the bones of the spine and hips.

Photon absorption provides gentle irradiation and at the same time provides accurate test results. At the same time, scanning is much faster than examination on X-ray machines.

The principle of the X-ray examination is the passage of X-rays through the patient's body in a fan-shaped beam oriented along one projection.

When the beam passes through dense tissues, their intensity drops, this is recorded by a special detector. The bone density is determined by a program based on mathematical integration. When the computer analysis ends, the program builds a tomographic image in several projections.

Training

To get objective results from a densitometry examination, you should:

• in the case when other organs with contrast have been examined for the last 2 weeks, you need to tell this to the attending physician;
• the presence of pregnancy, even in the first week, must be told to the attending physician;
• dress so that it is comfortable to lie still for 15 minutes;
• remove metal objects, gold chains, earrings, as they can affect the result;
• for a day or two before the examination, stop taking medications with calcium, including Vitrum, Kaltsinova.

It is necessary to tune oneself to hold a motionless posture indicated by the doctor, the time set for the examination, this is usually 30-40 minutes.

How is densitometry

Densitometry is performed in a specially equipped office. If an ultrasound densitometry is performed, then the patient lies on the couch by the apparatus. An ultrasound examination uses sensors that are put on the patient's finger. The study of the movement of ultrasound waves along the tissues of the bones takes 3-5 minutes.

When the examination is carried out on an X-ray machine, the patient lies down on the diagnostic table, the operator checks the posture, fixes it and asks to stay in the given posture for the required amount of time. A radiation source is located under the plane of the table, and an apparatus that records the results of the study is above the patient.

The sensor that reads the data moves over the body, measures the rate of passage of the irradiation, transmits the data to the computer. Here the totals are processed and analyzed. The result is obtained in the form of X-rays.

If the study is carried out on an installation with one block, then the specified part of the body is placed in the apparatus, the results of the study are issued by a computer program. Often, to improve the quality of the image, a part of the body is fixed with additional mounts.

During an X-ray examination, the image is transferred to a computer, where the program analyzes it. The procedure lasts from 10 minutes to ½ hour, depending on the scope of the examination.

What densitometry shows. Decoding the results

Densitometry shows:

• microarchitectonics of bone tissue;
• mineralization;
• microdamages on the bone trabeculae.

As a rule, the sections of the spine and hip joints are examined. According to the indications of the study, the general structure of the bones is assessed. The result of densitometry is deciphered according to the algorithm of computer programs.

3 survey parameters are important here:

• bone tissue density, unit of measurement - g / cm2; these are classic indicators SD, or in Russian it is written CO, which means the same, in percentage terms with the norms. Each unit of deviation from the standard doubles the risk of osteoporotic fractures;
• T-score, is analyzed as a statistical hypothesis; the obtained results of mineralization are compared with the standard data;
• Z-data, standardized; compares the results of the T-study with standard data for healthy people.

T- and Z-data have a standard grading scale that helps doctors assess the state of bone tissue in a subject:

1. Readings from 0 to -1.5 are considered normal.
2. Readings from -1.5 to -2.5 indicate a slight decrease in density, diagnosed as osteopenia.
3. Readings below -2.5 indicate complete osteoporosis.

Z values ​​are interpreted differently for children and adults:

• women in the period before menopause, bone density is estimated below normal at Z;
• men under 50 years of age, low tissue density is assessed at Z as a significant decrease in age norms;
• children and adolescents with Z are diagnosed with a pathology of bone tissue development.

Modern densitometers have standard indicators based on age and gender. The program compares the received data and decrypts the result.

In pediatrics, the diagnosis of osteoporosis is not established based on the results of densitometry, because the bone mass is not yet fully formed. This process ends only by the age of 25. The fact that the Z and T indices change slightly after 45 years is also taken into account, their decrease by 13-15% is not the basis for the diagnosis. Additional examination is required here.

The price of different types of research

Prices for studies of osteoporosis by different methods vary according to the type of medical institution, routine or emergency examination. Public hospitals set prices for all types of examinations cheaper than private medical centers. In private, prices depend on the level of the center, its popularity.

An appointment scan costs less than an on-call scan. The cost of the examination is influenced by the qualifications of a specialist, the availability of additional services.

A screening examination to determine the damage to the bone tissue of the spine and parts of the thigh bones on MRI costs about 15,000 rubles, if the study is carried out without a doctor's referral.

Price with referral - 14 250 rubles. There are benefits for people with disabilities, pensioners, medical workers, children under 12 years old, affected by the Chernobyl accident, blockade soldiers, veterans of the Great Patriotic War. For them, prices fluctuate between 12-13 thousand rubles.

Ultrasound densitometry is an examination using such different devices, which is evaluated differently in different cities.

On average, it costs from 622 rubles. for 2 places of examination up to 700 rubles. for 1st place. Prices are set differently in different cities of the country. So, in Voronezh, a patient will pay 845 rubles for the examination of 6 places, in Moscow up to 175 places are examined in different centers, the average price is 2205 rubles.

Article formatting: Lozinsky Oleg

Video about Densitometry

What is densitometry, how is it done:

The main purpose of densitometry- identification of signs of osteoporosis.

A diagnostic study is indicated in cases where there is a risk of a decrease in the mineralization of bone structures. It is recommended to prescribe the procedure to women with early menopause. The densitometry method is used for hyperparathyroidism, with the appearance of various injuries. Bone density should be checked in patients taking glucocorticoids.

The procedure can be performed using X-ray or ultrasound equipment. When X-ray densitometry is prescribed, images of the bones are taken. The use of this method is prohibited during pregnancy.

Ultrasound densitometry is done using a special apparatus that measures the speed of movement of an ultrasound wave along the structure of bones.

All results undergo computer (digital) processing, during which the obtained data are compared with the established indicators. The average values ​​of bone strength found in people of the same age and gender are taken as the norm.

Indications

Densitometry makes it possible to determine the mechanical strength of the bone to stress. It is also used to assess the effectiveness of the treatment undertaken in osteoporosis.

1. Densitometry is prescribed for patients with impaired bone mineralization.
2. It is recommended to undergo examination for women in the climacteric period, and for men after reaching 60 years of age.
3. It is advisable to determine bone density when taking medications containing calcium.
4. It is necessary to undergo densitometry for women with a long period of breastfeeding and with a large number of births.

An increased susceptibility to osteoporosis is detected in people with low weight or lack of sex hormones. The disease often develops in the presence of a burdened heredity, with an inactive mode of behavior and forced hypodynamia (immobilization or disability).

Bone density is often compromised by strict diets. People who abuse alcohol are prone to osteoporosis. Inappropriate nutrition with a lack of calcium and vitamin D can also affect bone strength.

Osteoporosis can develop with ailments of the thyroid gland. So, hyperthyroidism is usually accompanied by increased metabolism and excessive excretion of calcium.

Method advantages

1. Ultrasound densitometry has no contraindications. It can even be used on patients who have received radiation therapy.
2. The procedure does not cause pain and is very informative.
3. The method does not require preliminary preparation.
4. The advantages of the method include its simplicity, low cost and efficiency.

In 10 minutes of the procedure, it is possible to determine and analyze the quantitative content and composition of minerals in the bone tissue, to predict the risk of fractures.

After taking measurements, the specialist issues a conclusion. The attending physician, on the basis of the densitometry data, prescribes the necessary therapy and gives recommendations for the prevention of osteoporosis.

Classical densitometry is a study using low-dose X-rays. Bone density is determined automatically by a digital diagnostic unit: depending on how much X-ray radiation is attenuated when passing through the bones. The procedure does not create a high radiation load and is safe for the body.

Training

Any patient preparing for densitometry needs a few days before the procedure:

• Stop taking medications containing calcium and phosphorus
• Avoid foods high in foods
• Do not schedule other X-ray examinations with contrast (barium), as this may distort the diagnostic results

If the patient is a woman and she is about to undergo X-ray or CT densitometry, it is necessary to make sure that there is no pregnancy: even low doses of X-rays can harm the fetus.

Before the X-ray densitometry, you should also tell your doctor about any other radiation tests that have been done in the previous year. This is important for calculating the permissible radiation exposure.

Immediately before the procedure, it is required to remove and remove from the pockets all metal accessories and other objects that may cause inaccuracies in the research results.

Densitometry

The X-ray densitometry procedure is performed in a separate room where the diagnostic equipment is installed. Typically, densitometry examines the spine and femoral neck. The patient lies down on the table of the densitometer, and the part of the apparatus where the ray tube (sensors) is located is fixed above the examined area of ​​the body. Depending on the area of ​​examination, the person may be asked to lie on their back or take a certain body position.

Then the technologist turns on the apparatus, and scanning begins. An image is transferred to the screen of the device, and the densitometer computer begins to process the data. The patient does not experience any sensations during the diagnosis process. For the results to be as accurate as possible, it is not recommended to move during the procedure.

The total duration of the study is 10-20 minutes, then the specialist prepares and issues the results. The examined person does not need supervision and can immediately leave the clinic.

Densitometry of local areas (for example, only the bones of the forearm with delayed union of a fracture) takes less time than a full examination. In such cases, the patient is not placed on the table; only the examined part of the body (limb) is placed under the sensor.

The cost of densitometry depends on the number of areas examined.

A healthy person is recommended to undergo a study every 2 years in order to notice signs of a deficiency of minerals in the bones in time and to prevent the development of osteoporosis. The survey results should be saved in order to track the dynamics of changes in the future.

Indications and contraindications

The procedure is performed to detect a decrease in bone density. It is recommended for everyone who may experience this disorder:

• For persons over 40 years of age as a preventive procedure
• Postmenopausal women
• Elderly men
• Patients with diseases and disorders accompanied by the loss of calcium and other minerals (prolonged bed rest, chronic diseases of the digestive system, kidneys, liver, some metabolic diseases)
• Patients with repeated or long-term non-healing fractures
• For symptoms of bone abnormalities (eg, bone pain) with no known cause
• If you have risk factors for osteoporosis (such as being overweight or underweight)
• With prolonged use of hormonal or other drugs that disrupt mineral metabolism

There are few contraindications to the study:

• Pregnancy (with X-ray densitometry)
• Pain syndrome, involuntary movements and other conditions due to which the patient cannot remain motionless during the examination

Densitometry results

Data analysis during the study is carried out automatically. After the completion of the procedure, the device gives out two indicators: T-score and Z-score.

The T-score shows the deviation of the patient's bone density relative to the general norm. The indicator is considered normal if it is 1 point or higher. If a T-score is determined from - 1 to - 2.5 points, then this is the basis for the diagnosis of osteopenia. This is the name given to decreased bone density, which can predispose to osteoporosis. If the T-score is less than 2.5 points, the patient is diagnosed with osteoporosis. In such cases, bone mineral density is critically low: fractures are possible.