Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 1: Hip Geometry

Broy, Susan B.; Cauley, Jane A.; Lewiecki, Michael; Schousboe, John T.; Shepherd, John; Leslie, William D.

doi:10.1016/j.jocd.2015.06.005

Cited by 81 publications

(67 citation statements)

References 80 publications

(77 reference statements)

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“…Hip Structural Analysis (HSA; Hologic, Bedford, MA, USA) and Advanced Hip Assessment (AHA; GE-Lunar, Madison, WI, USA) are two recently developed software products that can be applied to a standard DXA scan to automatically derive various parameters related to bone geometry and bone strength, including hip axis length (HAL), cross sectional area (CSA), outer diameter (OD), section modulus (SM), buckling ratio (BR), cross-sectional moment of inertia (CSMI) and neck shaft angle (NSA) (86,87). According to the ISCD 2015 official positions, among hip geometry parameters derived from DXA, only the HAL is associated with hip fracture risk in postmenopausal women (88). HAL, by definition, is the distance (in mm) from the lower base of the greater trochanter, through the femur neck, to the inner pelvic brim (Figure 4).…”

Section: Dxa In Osteoporosismentioning

confidence: 99%

Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia

Guerri

Mercatelli

Gómez

et al. 2018

Quant. Imaging Med. Surg.

100

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Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs. Several imaging techniques are currently available for the non-invasive investigation of bone and muscle mass and quality. Conventional radiology, dual energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound often play a complementary role in the study of osteoporosis and sarcopenia, depicting different aspects of the same pathology. This paper presents the different imaging modalities currently used for the investigation of bone and muscle mass and quality in osteoporosis and sarcopenia with special emphasis on the clinical applications and limitations of each technique and with the intent to provide interesting insights into recent advances in the field of conventional imaging, novel high-resolution techniques and fracture risk.

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Section: Dxa In Osteoporosismentioning

confidence: 99%

Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia

Guerri

Mercatelli

Gómez

et al. 2018

Quant. Imaging Med. Surg.

100

View full text Add to dashboard Cite

show abstract

“…It can be measured manually or with commercially available DXA software (Hip Structural Analysis (HSA) from Hologic, Bedford, MA, USA; and Advanced Hip Assessment (AHA) from General Electric (GE Lunar, Madison, WI, USA). HAL varies according to ethnicity and gender, with a longer HAL associated with greater risk of hip fracture, even when adjusted for age, height, weight, and femoral neck BMD [16]. Asians typically have a shorter HAL than other ethnicities, and men typically have a longer HAL than women [16].…”

Section: Hip Access Lengthmentioning

confidence: 99%

“…HAL varies according to ethnicity and gender, with a longer HAL associated with greater risk of hip fracture, even when adjusted for age, height, weight, and femoral neck BMD [16]. Asians typically have a shorter HAL than other ethnicities, and men typically have a longer HAL than women [16]. A recent review of the studies evaluating the correlation of HAL and hip fractures in multiple populations found that HAL predicts hip fractures in postmenopausal women, but not in men [16].…”

Section: Hip Access Lengthmentioning

confidence: 99%

“…Asians typically have a shorter HAL than other ethnicities, and men typically have a longer HAL than women [16]. A recent review of the studies evaluating the correlation of HAL and hip fractures in multiple populations found that HAL predicts hip fractures in postmenopausal women, but not in men [16]. A subsequent publication analyzed a large database of patients (4738 men and 50,420 women) in Manitoba, Canada; it was concluded that greater HAL measured by DXA is associated with increased incident HF risk in both men and women, and this risk is independent of BMD and FRAX probability [21].…”

Section: Hip Access Lengthmentioning

confidence: 99%

“…The results were presented in a series of six publications that identified new ISCD Official Positions, with the rationale for establishing each of them [12][13][14][15][16][17]. These publications were accompanied by an executive summary that included all ISCD Official Positions [11].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Vignettes: Using Non-BMD Measurements in Clinical Practice

Lewiecki

2015

Clinic Rev Bone Miner Metab

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Dual-energy X-ray absorptiometry (DXA) is a well-established clinical tool for measuring bone mineral density (BMD) in the assessment of patients at risk of fracture. DXA is commonly used to diagnose osteoporosis, assess fracture risk, and assess the skeletal effects of treatment. Non-BMD DXA measurements, such as vertebral fracture assessment, hip access length, and trabecular score, have clinical applications that can guide patient treatment decisions. Quantitative computed tomography (QCT) measures three-dimensional volumetric BMD that is correlated with fracture risk. QCT measurements of the hip can also be used to generate a two-dimensional DXAequivalent areal BMD and T-score that can be used for diagnosis of osteoporosis and the assessment of fracture risk in the FRAX algorithm. Opportunistic measurements of BMD obtained with CT scans evaluating non-skeletal conditions have potential clinical utility in identifying patients at high risk of fracture. This is a collection of clinical vignettes that illustrate potential applications of non-BMD DXA measurements and CT scanning in the management of patients at risk of fracture.

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