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Using Algorithms to Diagnose Osteoporosis

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Osteoporosis is a complicated condition where the bone mass density of a person which slowly declines to a point where a low trauma even will trigger a fracture that most likely occur in the hip, spine or wrist.

Doctors are held to a high standard of care to diagnose and treat osteoporosis. During the process of diagnose as many physicians will use an algorithm that assist them in the decision-making and for treatment options.

An algorithm is a set of rules or a step-by-step procedure that allows the reader to produce a solution to a given problem based upon the results at each step. Doctors often use algorithms in the diagnosis of diseases to help follow a standard of care and to use a plan that is proven successful through clinical trials and research.

In the case of algorithms in the diagnosis of osteoporosis physicians have several from which to choose, but all of which and at the same place. Some of these algorithms are more detail than others and all could include information about the condition diagnosis and treatment.

The basic algorithm is a decision tree in which the physician or nurse practitioner can choose to continue to utilize education of the individual to increase the level of compliance with medication and decrease the risk of bone fractures throughout the process of diagnoses.

Most algorithms will also determine whether the individual is taking a calcium supplement, receiving enough vitamin D, vitamin K2 and magnesium as well is getting appropriate weight-bearing exercises, stop smoking and decrease alcohol intake if appropriate.

Another step of the algorithm will help the physician determine if the individual has any clinical evidence of osteoporosis. This evidence can present as a height loss of more than 1.5 inches, and low-impact fractures of the hip wrist or spine.

If the patient does have evidence than the physician may consider measurement of bone mass density for monitoring as well is screening for secondary illnesses is they are not postmenopausal women. This means that when osteoporosis presents an individual who is not a postmenopausal woman, the majority of osteoporosis diagnoses, then the physician will also find it necessary to discover the underlying reason for the diagnosis of osteoporosis which may include a secondary medical condition.

Patients who are postmenopausal and using hormone replacement therapy or not will find their physicians recommends a specific diagnostic x-ray (DXA) to get a baseline reading of the bone mass density which they currently have. This x-ray procedure can be repeated on an annual basis to follow bone mass density over time. Before hormone replacement therapy was found to produce negative results with breast cancer physicians found that the estrogen protected a woman’s bones and she would not require further testing or monitoring until she stopped taking the estrogen.

Patients can be started on one of the bisphosphonates, a class of medication that decreases bone loss. If they are in tolerant to the oral medications there are injectable forms and nasal sprays which can continue to offer the same benefits. While these medications are able to assist in individual and building more bone mass the particular bone mass built is not always of the same micro-structure as that of normal bone and may be weaker than normal bone.

When in bone mass density breeding is completed and the risk is deemed to be low than the physician will recommend monitoring the individual every two to three years to keep an eye on the situation. Individuals who are monitored will also find recommendations from their physician to improve their nutritional intake of calcium, vitamin D, vitamin K two and magnesium. As well as these particular vitamins and minerals it will also be recommended that they stop smoking and decrease any alcohol intake to decrease their bone loss. Adults who also add weight-bearing exercises to their daily activities will find an improvement in their risk tolerance.

These osteoporosis algorithms help the physician to make decisions regarding diagnoses and treatment but do not answer all the questions and individual scenarios that can occur. In these situations the doctor must rely on their own expertise in education. Although algorithms for any disease entity is an important element to diagnosis and treatment it is not the only information the physician uses to complete their decision-making.

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