Bone/ skeletal gives the
structural strength to a body and also helps to protect the internal organs and
fragile of body tissues. So called,
osteoporosis is a kind of metabolic bone disease which characterized by the
excessive bone loss associated with an increased risk of fractures.
Osteoporosis has been defined as a “disease characterized by low bone mass and
micro-architectural deterioration of bone tissue, leading to enhanced bone
fragility and a consequent increase in fracture risk”. Osteoporosis effect
the millions of the people worldwide and have major impact on the healthcare
resources. Osteoporosis represents
a major non-communicable disease of today and is set to increase markedly in
the future. There is underutilization of the measures available to combat the
disease and there is therefore a need for assessment of best practices in
prevention and treatment, since the adoption of these across countries can
potentially result in significant reductions in the burden of this disease.
The description of osteoporosis
captures the notion that low bone mass is an important component of the risk of
fracture, but other abnormalities such as micro-architectural deterioration
contribute to skeletal fragility. Ideally, clinical assessment of the skeleton
should capture all these determinants of fracture risk, but at present the
assessment of bone mass is the only aspect that can be readily measured in
clinical practice, and forms the cornerstone for the general management of
osteoporosis being used for diagnosis, risk prediction, and monitoring of
patients on treatment.
In India 29.9% of woman and 24.3%
of man between the ages of 20 and 79 years have low bone mineral density (BMD),
while among people more than 50 year of age 50% of a woman and 36 % of man have
osteoporosis.
A verity of the diagnosis
technique are present which are clinically used for the measurement of the bone
mineral content (BMC) or bone mineral density (BMD). Photon absorptiometry
based technique has been used in early 1980s, which are single photon
absorptiometry SPA, dual photon absorptiometry (DPA). This technique of the
bone assessment uses the radionuclide source like 125I, 153Gd
etc. this photon based techniques are suppressed by the x-ray based technique
like single energy x-ray absorptiometry (SEXA/SXA) and dual x-ray
absorptiometry (DEXA/DXA). The DXA become the gold standardof the assessment of
the bone and for the diagnosis of the osteoporosis. Apart from the DXA
quantitative computed tomography (QCT) are also used mostly as the substitute
of DXA. However due to the cost and complexity QCT has not been used as the
primary method for the diagnosis of the osteoporosis. Ultrasonic method is also
clinically consider as the diagnosis of the osteoporosis. Some of the
radiographic such as radiographic absorptiometry method can also be used for
the measurement of the BMD. Scattering method such as Compton-Scatter Imaging
Methods, Fixed-Point Compton-Scatter Methods etc. can also use as bone
densitometer.
Laser based technique also
present in the literature which can be used for the measurement of the BMD like
Dual x-ray and laser (DXL). DXL uses the x-ray energy in combination of the
laser which uses to measure the object thickness in order to determine all the
tissue component. Spectroscopy technique can also provide the batter prediction
of the osteoporosis. Raman based technique has been used for the measurement of
the BMD but clinically it has not been started. However some of the instrument
like spatially offset Raman spectroscopy (SORS) are in the clinical trial
stage, which be used for the measurement of BMD in finger, heel and other
peripheral part. As for my knowledge Fourier transform infrared spectroscopy
(FTIF) and nuclear magnetic resonance spectroscopy (NMRS) are also used in the
laboratory for the BMD measurement but clinically not accepted till date.
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