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Diagnosis

Osteoporosis. Diagnosis. NOF. Osteoporosis. Diagnosis. S P I N E. SPINE . Outside look. Inside structure . NORMAL . or. OSTEOPOROTIC. You can not diagnose Osteoporosis by looking at the teeth. Medical history. n. Risk factor assessment. . Physical examination. n.

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Diagnosis

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  1. Osteoporosis Diagnosis OSTEOPOROSIS

  2. NOF OSTEOPOROSIS

  3. Osteoporosis Diagnosis S P I N E OSTEOPOROSIS

  4. SPINE Outside look Inside structure NORMAL or OSTEOPOROTIC OSTEOPOROSIS

  5. You can not diagnose Osteoporosis by looking at the teeth OSTEOPOROSIS

  6. Medical history n Risk factor assessment  Physical examination n Height assessment  Laboratory tests, as appropriate n Bone mineral density (BMD) testing n Diagnosis of Postmenopausal Osteoporosis (PMO): Clinical Evaluation Diagnosis of Postmenopausal Osteoporosis (PMO): Clinical Evaluation OSTEOPOROSIS

  7. Osteoporosis Diagnosis Osteoporotic Patient OSTEOPOROSIS

  8. Osteoporosis Diagnosis Types of Vertebral fractures Normal Concave deformity Wedge Fracture Compression Fracture OSTEOPOROSIS

  9. Osteoporosis Diagnosis Lumbar Vertebrae: PATHOLOGY Osteoporotic (Fractured) vertebra From Remagen W 1989, Sandoz OSTEOPOROSIS

  10. Spinal CT No Bone left inside Abnormal vertebral body Normal OSTEOPOROSIS

  11. Osteoporosis Osteoporosis Routine Blood work: NORMAL Diagnosis Including biochemical bone profile OSTEOPOROSIS

  12. Osteoporosis Diagnosis Bone Markers NOT an easy test to interpret AM PM OSTEOPOROSIS

  13. OSTEOPOROSIS

  14. Testing Bone Strength Oh, no OSTEOPOROSIS

  15. … instead, we measure Bone Mineral Density OSTEOPOROSIS

  16. Which means… … we only measure the minerals OSTEOPOROSIS

  17. NOF OSTEOPOROSIS

  18. DXA is the gold standard Densitometer OSTEOPOROSIS

  19. DXA images / Reports Spine Hip Total Body OSTEOPOROSIS

  20. Neck Troch Inter -troch Regions of the proximal femur Forget the Ward’s triangle OSTEOPOROSIS

  21. WHO Criteria For Osteoporosis based on comparisons to the Young Adult Mean BMD • Normal < 1 SD below mean • Osteopenia (low bone mass) 1 SD < BMD < 2.5 below • Osteoporosis > 2.5 SD below • ‘Severe’ Osteoporosis > 2.5 SD below and fragility fractures T - score Kanis et al. JBMR 1994; 9:1137-41 OSTEOPOROSIS

  22. Instant Vertebral Assessment IVA generates a high-resolution image of the entire lateral spine in just 10 seconds, enabling physicians to visually assess vertebral status for a more accurate determination of fracture risk than just BMD alone OSTEOPOROSIS

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