Diffuse Idiopathic Skeletal Hyperostosis Causes Artificially Elevated Lumbar Bone Mineral Density Measured by Dual X-ray Absorptiometry

Schwartz, Jonathan B.; Rackson, Marlene

doi:10.1385/jcd:4:4:385

Cited by 13 publications

(4 citation statements)

References 3 publications

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“…Patients with ankylosing spondylitis showed significantly lower BMD measured by DXA at the lumbar spine and hip [26] while the opposite was found for patients with DISH [7, 8]. The expected findings were previously illustrated in a case report of a man with severe lumbar DISH who had high DXA BMD values, which were interpreted as false negative because the same patient’s distal radius BMD showed osteoporosis [9]. Higher DXA BMD values of the lumbar spine and hip were also reported in a study of 132 women with DISH [8].…”

Section: Discussionmentioning

confidence: 97%

“…It has been suggested that the fused segments are more prone to fracture even after minimal trauma [6]. On the other hand, different studies have shown consistently higher bone mineral density (BMD) in patients with hyperostosis, implying a lower fracture risk [7–9]. All of these previous studies were performed with dual energy X-ray absorptiometry (DXA), which measures two-dimensional areal BMD as a sum of all attenuating tissues in the beam projection.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density

et al. 2010

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SummaryRadiographs and spinal bone mineral density (BMD) were evaluated from 342 elderly men regarding possible effects of diffuse idiopathic skeletal hyperostosis (DISH) on vertebral fractures and densitometry measurements. Prevalent vertebral fractures were more frequent among men with DISH compared to men with no DISH even after fracture prevalence was adjusted for BMD. Paravertebral calcifications should be considered in patients with DISH when interpreting BMD measurements because both dual X-ray absorptiometry (DXA) and quantitative CT (QCT) densitometry may not be reliable.IntroductionThe purpose of this study is to evaluate the prevalence of DISH in older men and its association with vertebral fractures and with BMD determined by DXA and QCT.MethodsLateral radiographs of the spine were analyzed in a sample of 342 men aged ≥65 years participating in the MrOS Study concerning the presence and grade of DISH and vertebral fractures. Lumbar BMD was measured by both DXA (areal, grams per square centimeter) and QCT (volumetric, grams per cubic centimeter). The association between DISH, BMD, and presence of fractures was studied using χ2 and t tests.ResultsDISH was present in 52% (178/342) of the men. Men with DISH were older (mean, 75.1 vs 73.3, p < 0.05) and more likely to have prevalent fractures (28% vs 20%, p < p = 0.09). BMD assessed with DXA (1.08 vs 1.00 g/cm2, p ≤ 0.0001), but not with QCT (0.11 vs 0.11 g/cm3, p = 0.65), was significantly higher in men with DISH compared to men without DISH. Significantly lower BMD of men with both DISH and fractures compared to men with DISH but without fractures was only detected by QCT (−25%, 0.09 vs 0.12, p < 0.05). Both DXA BMD and QCT BMD were significantly higher in severe lumbar DISH (+22% and +31%, p < 0.0001), respectively.ConclusionDISH was associated with a higher prevalence of vertebral fractures in elderly men. Lumbar ossifications related to DISH should be considered when interpreting BMD measurements to predict their fracture risk.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density

et al. 2010

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“…In addition, measurement of L1‐L4 lumbar spine BMD was suspected to reflect age‐related artifacts (e.g., aortic calcification, ossification of the anterior spinal ligament, spinal osteoarthritis etc.) that make phenotypic characterization more difficult (Slosman et al 1990; von der Recke et al 1996; Liu et al 1997; Schwartz et al 2001). These artifacts may contribute to the above discrepancies as well, since both parents in each nuclear family are not necessarily healthy in our studied sample.…”

Section: Discussionmentioning

confidence: 99%

Complex segregation analyses of bone mineral density in Chinese

Liu

Qin

Zhou

et al. 2004

Annals of Human Genetics

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SummaryChina has the largest population in the world; approximately 7% of the total population suffers from primary osteoporosis. Osteoporosis is mainly characterized by low bone mineral density (BMD). In the present study, familial correlation and segregation analyses for spine and hip BMDs have been undertaken for the first time in a Chinese sample composed of 401 nuclear families with a total of 1,260 individuals. The results indicate a major gene of additive inheritance for hip BMD, whereas there is no evidence of a major gene influencing spine BMD. Significant familial residual effects are found for both traits, and heritability estimates (± SE) for spine and hip BMDs are 0.807(0.099) and 0.897(0.101), respectively. Sex and age differences in genotype-specific average BMD are also observed. This study provides the first evidence quantifying the high degree of genetic determination of BMD variation in the Chinese.

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“…Radiographic signs of DISH at the thoracic or lumbosacral spine have been associated with increased aBMD at the hip [11], spine [11] and radius [7] as well as an increased MI [8,12]. It has been discussed whether the elevated aBMD at the spine of DISH patients is merely due to ossified ligaments [13,14]. We present the first cross-sectional pQCT study of 30 DISH patients and 30 control subjects.…”

Section: Discussionmentioning

confidence: 98%

Patients with diffuse idiopathic skeletal hyperostosis do not have increased peripheral bone mineral density and geometry

et al. 2010

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Diffuse Idiopathic Skeletal Hyperostosis Causes Artificially Elevated Lumbar Bone Mineral Density Measured by Dual X-ray Absorptiometry

Cited by 13 publications

References 3 publications

Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density

Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density

Complex segregation analyses of bone mineral density in Chinese

Patients with diffuse idiopathic skeletal hyperostosis do not have increased peripheral bone mineral density and geometry

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