Osteoporosis Investigations Osteoporosis Treatment

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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 commit to user 26 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 Bones are living tissue, and calcium gets deposited and withdrawn daily from the skeleton.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 commit to user 27 treatment. For vertebral compressions, an orthopaedic intervention such as kyphoplasty or vertebroplasty can be a treatment option.

11. Strategies of Osteoporosis Reduction