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Tuesday, 1 December 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Diagnosis

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                                Osteoporosis

Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).


                               The Diagnosis 

According to the Clinical practice guidelines, the diagnosis and management of osteoporosis include screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations(131)

If you are experience certain symptom of osteoporosis, the tests which your doctor order include
1. Laboratory testsThe aim of the tests is to check for serum calcium, phosphate, creatinine, alkaline phosphatase and 25-hydroxyvitamin D and, additionally in men, testosterone(132), according to The Catholic University of Korea.

2. Dual energy X-ray absorptiometry (DXA)
Dual energy X-ray absorptiometry (DXA) is one most common test to measure the total bone density of including spine, hip, wrist etc... The test forms an important role in the evaluation of individuals at risk of osteoporosis,(133)(134).

3. Quantitative Ultrasound and computed tomography (QCT)
Quantitative ultrasound (QUS) is a portable and accurate technology used to evaluate skeletal status including bone density at the lumbar spine and hip without the use of ionizing radiation(137). In compared to the conventional dual energy x-ray absorptiometry (DEXA), quantitative ultrasound yielded results comparable to DEXA and may therefore be used for screening patients osteoporosis(135) and can be a helpful tool for assessing pathological fractures(136), especially for those with CRD(135)

Computed Tomography (CT) scanner.a technology for measuring properties of bone at peripheral skeletal sites for noninvasive bone mineral measurement(138) with greatest advantages of high precision and sensitivity of the vertebral spongiosa site(139) and the latter region of the skeleton, correlates well with the spinal fracture index(140)

Dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT), which are now the standard methods for assessing osteoporosis severity and treatment efficacy(141). But according to the Universitätsklinikum Schleswig-Holstein, in cross-sectional study of males with glucocorticoid-induced osteoporosis (GIO, quantitative computed tomography (QCT), High-resolution quantitative computed tomography (HRQCT)-based were more superior to DXA in diferentiating between patients with vertebral fracture status(142).

4. Etc.


References
Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(131) Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada(CMAJ)
(132) Current Recommendations for Laboratory Testing and Use of Bone Turnover Markers in Management of Osteoporosis by Jehoon Lee, M.D.1 and Samuel Vasikaran, M.D.(PMC)
(133) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis by Glen M Blake and Ignac Fogelman(PMC)
(134) The clinical role of dual energy X-ray absorptiometry by Blake GM1, Fogelman I.(PubMed)
(135) Assessment of osteoporosis by quantitative ultrasound versus dual energy X-ray absorptiometry in children with chronic rheumatic diseases by Hartman C1, Shamir R, Eshach-Adiv O, Iosilevsky G, Brik R.(PubMed)
(136) Review of comparative studies between bone densitometry and quantitative ultrasound of the calcaneus in osteoporosis by Flöter M1, Bittar CK, Zabeu JL, Carneiro AC.(PubMed)
(137) Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group by Glüer CC.(PubMed)
(138) Quantitative computed tomography in assessment of osteoporosis by Genant HK1, Block JE, Steiger P, Glueer CC, Smith R.(PubMed)+
(139) Osteoporosis: assessment by quantitative computed tomography by Genant HK, Ettinger B, Cann CE, Reiser U, Gordan GS, Kolb FO.(PubMed)
(140) Assessment of metabolic bone diseases by quantitative computed tomography by Richardson ML, Genant HK, Cann CE, Ettinger B, Gordan GS, Kolb FO, Reiser UJ.(PubMed)