Osteoporosis is widely discussed in the recent years and, bone mineral density (BMD) is frequently ordered. Our purpose is to determine the diagnosis and prediagnosis in patients who have measured BMD in a certain period of time based on orders from different clinics and to evaluate in terms of osteoporosis. Age, height, weight, age of menopausis, name of the clinics which ordered BMD, diagnosis of patients and lomber (L2-L4), femur (neck, wards) BMD values and t scores detected by Lunar DPX (6956) DEXA of 202 patients who were measured in bone mineral densitometry during a unit 6 months period were recorded. BMD values were classified as normal, osteopenic and osteoporotic according to WHO criteria. 105 patients were from Physical Medicine and Rehabilitation clinics, 80 were from Obstetrics and Gynecology, 7 were from Endocrine Unit, 3 were from Internal Medicine, 2 were from Orthopaedics and Traumatology, 2 were from Pediatrics, 2 were from Neurology and 1 were from Infectious Diseases clinics. 56% of patients sent from Physical Medicine and Rehabilitation had diagnosis of osteoporosis. Osteoporosis is detected in 36% of them according to lomber scores and in 18.6% of them according to femur scores. Rate of the patients sent from Obstetrics and Gynecology with menopause was 62.5%. Osteoporosis was detected in 17.5% of them according to lomber scores and in 4.1% according to femur scores. As aresult, DEXA is the most frequently applied measurement in diagnosis of osteoporosis and is accepted as golden standart in the present time. Considering conditions of our country, we suggest use of DEXA in a suitable group of patients with a correct indication.Key words: Osteoporosis, bone mineral densitometry
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GIRIS VE AMAÇ
Osteoporoz düsük kemik kütlesi ve kemik dokusunun mikroyapisinin bozulmasindan dolayi kemik kirilganliginda ve fraktür riskinde artis ile karakterize sistemik bir iskelet sistemi hastaligidir (1).Hem kemiklerde zayiflik hem de kemik kütlesinde azalma ile seyreden ve çok sayida kadin ve erkegi etkileyen kronik bir hastaliktir. Fraktürler görüldükten sonra tani konulmasi ise önemli bir morbidite ve mortaliteye sebep olabilmektedir (2-4).Osteodansitometre ile bireylerin KMY degerlerini belirlemek mümkündür. Kemik mineral yogunlugu ölçüm isteminin bazi stratejiler çerçevesinde yapilmasi gereklidir. Bireyin risk faktörleri, düsük vücut kitle indeksi, fraktürler,kifoz bunlar arasinda sayilabilir (5). Osteoporoz ciddi bir saglik problemi olup, uygun tarama, tani ve tedavi yaklasimlari gerekmektedir (6). Ülkemizde özellikle son yillarda oldukça yogun olarak hastalara KMY ölçümü istenmektedir. Biz de bu yogunluk içerisinde, klinigimiz bünyesinde Osteoporoz ve Kemik Mineral Dansitometre ünitesinde 6 ay süresince çekimi yapilan olgulari inceledik. Amacimiz bu olgularin klinikler bazinda tani ve ön tanilarinin dökümünü yapip, osteoporoz açisindan degerlendirmekti.
MATERYAL METOD
Kemik mineral dansitometre ve osteoporoz ünitesinde çekimleri yapilan toplam 202 hasta çalismaya dahil edildi. Hastalarin yas, boy, kilo, menopoz yaslari ile ölçüm isteminini hangi kliniklerden hangi ön tanilarla yapildiklari kaydedildi. Istem yapilirken belirtilen tani dagilimi; osteoporoz, osteoporoz süphesi, cerrahi menopoz, osteoporoz+ek hastalik, tanisi belli olmayanlar olarak gruplandirildi ve klinikler bazinda degerlendirildi. Hastalarin Lunar DPX (6956) DEXA cihazi ile çekilen lomber (L2-L4) ve femur (boyun,wards) KMY degerleri ve t skorlari belirlendi. KMY sonuçlari Dünya Saglik Örgütüne (WHO) göre normal, osteopenik ve osteoporotik olarak siniflandirildi (7).Hastalarin ortalama ve yüzde degerleri SPSS for windows paket programi kullanilarak yapildi.
