APPLICATIONS OF BONE DENSITOMETRY FOR OSTEOPOROSIS
Section snippets
BONE DENSITOMETRY AND FRACTURE RISK
Osteoporosis is widely accepted as “a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.”11 Because of the widespread availability of bone densitometry systems, the diagnosis of osteoporosis increasingly is being based on bone density measurements. The World Health Organization (WHO) working group has defined osteoporosis as a BMD value 2.5 or greater standard
Dual X-Ray Absorptiometry
The fundamental principle behind DXA is measurement of the transmission through the body of x-rays with two different photon energies. Because of the dependence of the attenuation coefficient on atomic number and photon energy, measurement of the transmission factors at two energies enables the area densities (i.e., mass per unit projected area) of two different types of tissue to be inferred. In DXA scans, these are taken to be bone mineral (hydroxyapatite) and soft-tissue, respectively.
A DXA
INTERPRETATION OF BONE DENSITOMETRY STUDIES
Primary care physicians and other clinicians requesting DXA scans usually have little or no expertise in interpreting the computer printout from bone densitometry studies. Thus, radiologists and others issuing clinical reports on the results of scans need to present a clear interpretation that provides the requesting physician with the necessary information on which to base decisions. Among the difficulties encountered in this task is the fact that there is little consensus in regards to how
Bone Densitometry and Fracture Risk
During the past 20 years, epidemiologic studies evaluating the association between BMD measurements and fracture risk have influenced the growth of the clinical applications of bone densitometry and have encouraged the rapid evolution of new techniques. Such studies have confirmed that BMD measurements in the peripheral and axial skeleton and QUS measurements in the calcaneus are predictive of fracture risk, with risk ratios in the range 1.5 to 2.5. Additional studies will be important in the
References (64)
- et al.
Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures
Lancet
(1996) - et al.
Bone density at various sites for prediction of hip fractures
Lancet
(1993) - et al.
Peripheral measurement techniques for the assessment of osteoporosis
Semin Nucl Med
(1997) - et al.
Ultrasonographic heel measurements to predict hip fracture in elderly women: The EPIDOS prospective study
Lancet
(1996) - et al.
Assessment of fracture risk by bone density measurements
Semin Nucl Med
(1997) - et al.
The European spine phantom: A tool for standardization and quality control in spinal bone mineral measurements by DXA and QCT
Eur J Radiol
(1995) - et al.
In-vitro assessment of the relationship between acoustic properties and bone mass density of the calcaneus by comparison of ultrasound parametric imaging and quantitative computed tomography
Bone
(1997) - et al.
The clinical relevance of calcaneus bone mineral measurements: A review
Bone Miner
(1988) - et al.
The impact of bone size on broadband ultrasound attenuation
Bone
(1995) - et al.
Screening for osteopenia and osteoporosis: Do the accepted normal ranges lead to overdiagnosis?
Osteoporosis Int
(1997)
Broadband ultrasonic attenuation predicts fractures strongly and independently of densitometry in older women
Arch Intern Med
Axial and appendicular bone density predict fractures in older women
J Bone Miner Res
Should BMD be measured at multiple sites to predict fracture risk in elderly women?
J Bone Miner Res
Four reasons to avoid the use of BMD T-scores in treatment decisions for osteoporosis
J Bone Miner Res
New generation dual x-ray absorptiometry scanners increase radiation dose to patients and staff
J Bone Miner Res
A longitudinal study of supine lateral DXA of the lumbar spine: A comparison with posteroanterior spine, hip and total body DXA
Osteoporosis Int
Long-term precision of DXA scanning assessed in forty postmenopausal women followed over seven years
J Bone Miner Res
Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone
J Bone Miner Res
Consensus Development Conference Diagnosis, prophylaxis and treatment of osteoporosis
Am J Med
Changes in BMD substantially underestimate the anti-fracture effects of alendronate and other antiresorptive drugs
J Bone Miner Res
A controlled trial of raloxifene (LY139481) HCl: Impact on bone turnover and serum lipid profile in healthy postmenopausal women
J Bone Miner Res
A single bone density measurement can predict fractures over 25 years
Calcif Tissue Int
Monitoring skeletal response to therapy in early postmenopausal women: Which bone to measure?
J Bone Miner Res
Discrepancies in normative data between Lunar and Hologic DXA systems
Osteoporosis Int
Universal standardization for dual x-ray absorptiometry: Patient and phantom cross-calibration results
J Bone Miner Res
Noninvasive assessment of bone mineral and structure: State of the art
J Bone Miner Res
Broadband ultrasound attenuation signals depend on trabecular orientation: An in-vitro study
Osteoporosis Int
Three quantitative ultrasound parameters reflect bone structure
Calcif Tissue Int
Quantitative ultrasound techniques for the assessment of osteoporosis— expert agreement on current status
J Bone Miner Res
Comparisons of non-invasive bone mineral measurements in assessing age-related loss, fracture discrimination and diagnostic classification
J Bone Miner Res
The epidemiology of quantitative ultrasound: A review of the relationships with bone mass, osteoporosis and fracture risk
Osteoporosis Int
A new reflection quantitative ultrasound system: Preliminary results of multi-site bone measurements. In Proceedings of the 12th International Bone Densitometry Workshop, Crieff, 1997
Osteoporosis Int
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Address reprint requests to Glen M. Blake, PhD, Department of Nuclear Medicine, Guy's Hospital, St. Thomas Street, London SE1 9RT, United Kingdom