HSE 113 Deakin University Management Of Osteoporosis Video Case Report
HSE 113 Deakin University Management Of Osteoporosis Video Case Report
Osteoporosis results from reduced bone mass and disruption of the micro-architecture of bone (fig 1)1),, giving decreased bone strength and increased risk of fracture, particularly of the spine, hip, wrist, humerus, and pelvis. The risk of fractures increases steeply with age (fig 2)2) and most of those affected are over 75.1 2 Globally, osteoporotic fractures caused an estimated 5.8 million disability adjusted life years in the year 2000w1 and are also associated with increased mortality. Hip fractures (fig 3)3) result in loss of independence for at least a third of people with osteoporosis, and vertebral fractures (fig 4)4) cause height loss, chronic pain, and difficulty with normal daily activities.
Bone mineral density (BMD) can be measured by a variety of techniques at several skeletal sites. Once measured, the manufacturers’ software uses the BMD to calculate a T-score and/or Z-score. Both T-scores and Z-scores are derived by comparison to a reference population on a standard deviation scale. The recommended reference group for the T-score is a young gender-matched population at peak bone mass, while the Z-score should be derived from an age-matched reference population. T-scores and Z-scores are widely quoted in scientific publications on osteoporosis and BMD studies, and are the values used for DXA diagnostic criteria and current clinical guidelines for the management of osteoporosis. Errors in BMD measurement, differences in reference populations, and variations in calculation methods used, can all affect the actual T-score and Z-score value. Attempts to standardize these values have made considerable progress, but inconsistencies remain within and across BMD technologies. This can be a source of confusion for clinicians interpreting BMD results. A clear understanding of T-scores and Z-scores is essential for correct interpretation of BMD studies in clinical practice. KeywordsDXA-Bone mineral density- T-score- Z-score.
Bone mineral density (BMD) can be measured
by a variety of techniques at several skeletal sites. Once
measured, the manufacturers’ software uses the BMD to
calculate a T-score and/or Z-score. Both T-scores and
Z-scores are derived by comparison to a reference popu-
lation on a standard deviation scale. The recommended
reference group for the T-score is a young gender-matched
population at peak bone mass, while the Z-score should be
derived from an age-matched reference population.
T-scores and Z-scores are widely quoted in scientific pub-
lications on osteoporosis and BMD studies, and are the
values used for DXA diagnostic criteria and current clinical
guidelines for the management of osteoporosis. Errors in
BMD measurement, differences in reference populations,
and variations in calculation methods used, can all affect
the actual T-score and Z-score value. Attempts to stan-
dardize these values have made considerable progress, but
inconsistencies remain within and across BMD technolo-
gies. This can be a source of confusion for clinicians
interpreting BMD results. A clear understanding of
T-scores and Z-scores is essential for correct interpretation
of BMD studies in clinical practice
