Wiener Medizinische Wochenschrift

, Volume 162, Issue 5–6, pp 99–109 | Cite as

Diagnose von Osteoporose beim geriatrischen Patienten: Möglichkeiten und Grenzen

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Zusammenfassung

Osteoporose und damit einhergehende Knochenbrüche stellt für den alten Patienten eine Erkrankung mit relevanter Beeinflussung der Lebensqualität, erhöhter Morbidität und Mortalität dar. Therapeutische Ansätze bei Osteoporose, insbesondere medikamentöse Therapien zur Fraktursenkung, werden nur nach vorangegangener Osteoporosediagnostik eingeleitet. Folglich kommt der Osteoporosediagnostik für ein optimiertes Patientenmanagement eine Schlüsselrolle zu. Anamnese, körperliche Untersuchung, planares Röntgen, Osteodensitometrie und ein osteologisches Basislabor stellen die relevanten diagnostischen Methoden zur Diagnostik von Osteoporose dar. Bei speziellen Fragestellungen, wie zum Beispiel der Erkennung von okkulten Frakturen nach Sturzgeschehen, sind gegebenenfalls auch weitere bildgebende Verfahren wie Computertomographie, Magnetresonanz oder die Knochenszintigraphie einzusetzen. Es stellt sich aber die Frage, wie all diese Verfahren beim geriatrischen Patienten effizient in der Diagnostik eingesetzt werden können. Unter besonderer Berücksichtigung klinisch relevanter Fragestellungen werden die unterschiedlichen diagnostischen Methoden bei Osteoporose mit deren Möglichkeiten als auch Limitationen sowie relevante Zielsetzungen der Osteoporosediagnostik bei geriatrischen Patienten dargestellt.

Schlüsselwörter

Osteoporose Diagnostik Frakturen Alter Patient Geriatrischer Patient 

Diagnosis of osteoporosis in geriatric patients – possibilities and limitations

Summary

Osteoporosis with its increased risk of low-trauma fractures has to be regarded as a disorder with significant influence on quality of life, increased morbidity and mortality in the elderly. Therapies of osteoporosis, in particular drug therapies aiming to reduce the fracture risk, are in general only initiated after diagnostic procedures prior to the start of osteoporosis therapy. Consequently, diagnosis of osteoporosis plays a key role in optimized patient care and management. Medical history, physical examination, planar X-ray, osteodensitometry and a range of laboratory parameters make up the key steps in the diagnostic work up of osteoporosis. In some clinical settings such as the investigation of possible occult fractures after falls, additional imaging methods including computed tomography, magnetic resonance imaging, and bone scintigraphy may be necessary to make up adequate diagnosis. However, it has to be questioned in which way all these diagnostic investigations can be effectively used in the diagnostic work up of geriatric patients. The article will give an overview of the different diagnostic methods with their possibilities and limitations and will present possible diagnostic work flows based on frequent clinical settings seen in geriatric patients.

Keywords

Osteoporosis Diagnosis Fracture Elderly Geriatric patient 
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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.1. Medizinische AbteilungKlinikum Klagenfurt am WörtherseeKlagenfurtAustria
  2. 2.Ludwig Bolzmann-Institut für Osteologie im Hanusch-Krankenhaus der WGKK und Unfallkrankenhaus Meidling der AUVA, 1. Medizinische AbteilungHanusch-KrankenhausWienAustria

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