State University of Medicine and Pharmacy Nicolae

Testemițanu

DEPARTMENT OF RADIOLOGY AND

IMAGING

Osteoporosis and osteodestruction,radiographic analysis

SUBMITTED BY:MURUGAN RAJASREE AJAYALAL

GROUP:M1961
DATE:02/12/2021
Osteoporosis
• Osteoporosis is the most common metabolic bone disease, with a wide distribution among the
elderly. This disease entity can have a variety of causes and can be classified as either primary
or secondary osteoporosis
• Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs
when the creation of new bone doesn't keep up with the removal of old bone.
• White and Asian women — especially those who are past menopause — are at highest risk.
Osteoporosis symptoms
Back pain, caused by a fractured or collapsed vertebra
Loss of height over time
A stooped posture
A bone fracture that occurs much more easily than expected
Dxa scan

Dual-energy X-ray absorptiometry (DXA) is a technique used to measure bone mineral

density. Two X-ray beams of different energy levels are aimed at a patient’s bones to
determine BMD.
LOW BONE MASS (MEDICALLY TERMED OSTEOPENIA): A
BMD DEFINES OSTEOPENIA AS A T-SCORE BETWEEN -1 AND -
2.5. THIS SIGNIFIES AN INCREASED FRACTURE RISK BUT
DOES NOT MEET THE CRITERIA FOR OSTEOPOROSIS.
OSTEOPOROSIS: A BMD GREATER THAN 2.5 STANDARD
DEVIATIONS FROM THE NORMAL (T SCORE LESS THAN OR
EQUAL TO -2.5) DEFINES OSTEOPOROSIS.
Pathology
 Osteoporosis can be localized or diffuse and be divided into:

 primary: no cause is identifiable

 postmenopausal (type 1): occurs in 50-65-year-olds females; disproportionate loss of cancellous bone as
compared to cortical bone resulting in more involvement of cancellous bone-rich areas, like vertebrae and ends
of long bones
 senile (type 2): occurs in the elderly; proportionate loss of cortical and cancellous bones affecting long bones
 idiopathic juvenile osteoporosis
 secondary (type 3): occurs due to a range of causes including
 endocrine disease (e.g. Cushing syndrome, hyperthyroidism, hyperparathyroidism, diabetes mellitus) 7
 chronic illness (e.g. COPD, chronic liver disease, multiple sclerosis, celiac disease) 7
 inflammation
 medications (e.g. steroids, phenytoin)
Radiographic features
Decreased bone density can be appreciated by decreased cortical thickness and loss of bony
trabeculae in the early stages in radiography. Bones like the vertebra, long bones (proximal
femur), calcaneum and tubular bones are usually looked at for evidence of osteoporosis.
Nevertheless, dual energy x-ray absorptiometry (DEXA) is the gold standard of diagnosing
osteoporosis
Other techniques
In CT
 Quantitative CT can measure bone mineralization and BMD, which is usually done in the
lumbar spine
Ultrasound
 Quantitative ultrasound of the calcaneal bone quality has recently emerged as a cost-efficient
screening tool for osteoporosis
MRI
 Bone marrow signal takes on a heterogeneous appearance with rounded focal fatty lesions
replacing normal marrow with coalescence often occurring
T1: heterogeneously hyperintense
T2: variable signal
Ct of Vertebral insufficiency fractures in severe Senile osteoporosis xray
osteoporosis
Osteodestruction

Different patterns of bone destruction are caused by a

variety of disease process affecting the bone.
Type of destruction is according to

• Intensity of bony involvement

• Aggression of the disease
• Ability of host bone to repair
• Age of patient must be considered when the lesions are evaluated.