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9. Osteoporosis Investigations
Osteoporosis investigations are performed through laboratory investigation and bone strength assessments.
a. Laboratory Investigation
The objective of laboratory investigation is to assure diagnosis of osteoporosis, to assess the risk of osteoporosis and to determine
causes of osteoporosis. In a primary laboratory investigation, a complete blood count is done to measure the serum calcium, phosphate,
albumin and liver transaminases as well as s erum alkaline phosphates‟.
Renal function is also assessed through blood urea nitrogen and creatinine. A plain x-ray is also suggested to check lateral
thoracolumbar spine or anteroposterior hip in case of indicated or suspected of bone fracture.
b. Bone Strength Assessment
Bone strength includes bone mass and bone quality. The latter one is not currently assessed accurately by any technologies for clinical
uses; therefore bone density is mainly used for clinical assessment of bone strength. In osteoporosis, bone mass must be decreased more than
30-40 of normal value and diagnosis using a plain x-ray is not sensitive enough to indicate this reduction to be visible on radiogram.
On the other hand, using a semi-quantitative method to assess radiogram from a plain x-ray film
, such as Singh‟s index, cannot perpustakaan.uns.ac.id
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control the assessment standard and therefore due to highly intra- observer and inter-observer, it is not suggested to be used.
According to WHO standard, only DXA can be used for bone mass measurements in order to diagnose osteoporosis and other
technologies such as quantitative ultrasonography QUS or peripheral DXA pDXA cannot replace DXA although they are useful in
screening people with high risk of osteoporosis.
10. Osteoporosis Treatment
Changes in the lifestyle such as physical activity, dietary habits and smoking can have a positive effect to treat osteoporosis. Taking calcium
and vitamin D supplements may also treat osteoporosis. The NIH has
determined that physical activity along with calcium consumption are two major factors affecting maximum achievement of bone mass. Bones are
living tissue, and calcium gets deposited and withdrawn daily from the skeleton. When the body does not consume enough calcium or does not
absorb it adequately, the bones become depleted, making them brittle and weak. Calcium is the main building block of bone and is essential for bone
health, but calcium intake alone does not ensure healthy bones. For adults 19 to 50 years, an estimated adequate daily calcium intake is 1,000 mg per
day NIH Consensus Development Conference Statement, 2000. Antiresorptive treatment such as bisphosphonates and
Selective Estrogen Receptor Modulators SERMs and
anabolic treatment such as intermittent
Parathyroid Hormone PTH may also be considered for perpustakaan.uns.ac.id
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treatment. For vertebral compressions, an orthopaedic intervention such as
kyphoplasty or vertebroplasty can be a treatment option.
11. Strategies of Osteoporosis Reduction