Radiographic absorptiometry: A simple method for determination of bone mass

Cosman, Felicia; Herrington, B.; Himmelstein, Sharon; Lindsay, Robert

doi:10.1007/bf01627076

Cited by 114 publications

(50 citation statements)

References 10 publications

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“…In vitro studies show that this method provides an accurate and precise assessment of bone mass (19). Further results indicate a significant correlation with radial single-photon absorptiometry (SPA) and spinal and femoral dual-photon absorptiometry (DPA) measurements in vivo (20). However, it should be noted that numerous physical factors that influence the radiographic image may also affect photodensitometry .…”

Section: Standard Methods and Their Perspectivesmentioning

confidence: 91%

Current methods and recent advances in the diagnosis of osteoporosis

Jergas

Genant

1993

Arthritis & Rheumatism

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Osteoporosis is a disease characterized by low bone mass, microarchitectural deterioration of bone tissue leading to increased bone fragility, and a consequent increase in fracture risk (1). The term osteoporosis is widely used clinically to mean generalized loss of bone, or osteopenia, accompanied by relatively atraumatic fractures of the spine, wrist, hips, or ribs. These osteoporotic fractures cause considerable morbidity, mortality, and public health cost (2,3). Bone mass, or density, is a major determinant of skeletal strength, and recent studies have shown that its quantification is predictive of future fracture risk (4-8).Several established methods provide highly accurate and precise means of determining bone mass (9,lO). However, factors other than bone mass, e.g., spatial distribution of bone, structural properties, etc., also contribute to skeletal strength (1 1,12). Most of these factors cannot be determined by the standard methods used today. In this report, clinically relevant techniques used routinely in the diagnosis of osteoporosis are reviewed. In addition, we provide an update on recent advances in the established methods as well as in methods that are currently under development.

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Section: Standard Methods and Their Perspectivesmentioning

confidence: 91%

Current methods and recent advances in the diagnosis of osteoporosis

Jergas

Genant

1993

Arthritis & Rheumatism

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“…In this method, a radiograph of a peripheral site, typically metacarpals and phalanges, is obtained placing a reference wedge of hydroxyapatite or aluminum close to the bone. BMD is then expressed relative to the density of this wedge material (45). Even if RA was limited to peripheral skeletal sites, the composite volume density and the composite area density derived by RA at the phalanges showed a good correlation with the standard measurements of BMD derived by DXA (r=0.69 and 0.68 respectively, at lumbar spine; r=0.63 and 0.67 respectively, at the femoral neck) (45).…”

Section: Conventional Radiographymentioning

confidence: 99%

“…BMD is then expressed relative to the density of this wedge material (45). Even if RA was limited to peripheral skeletal sites, the composite volume density and the composite area density derived by RA at the phalanges showed a good correlation with the standard measurements of BMD derived by DXA (r=0.69 and 0.68 respectively, at lumbar spine; r=0.63 and 0.67 respectively, at the femoral neck) (45). However, RA was time consuming and results were strongly influenced by multiple factors including operator expertise, X-ray beam intensity and soft tissue thickness (43).…”

Section: Conventional Radiographymentioning

confidence: 99%

Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia

Guerri

Mercatelli

Gómez

et al. 2018

Quant. Imaging Med. Surg.

110

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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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“…The technique has been described in detail earlier [21,26,28]. Briefly, fingers of the non-dominant hand and an aluminum wedge were radiographed with the available radiographic equipment at the site, using a non-screened pre-packed sealed industrial film by Kodak.…”

Section: Radiographic Absorptiometry Of the Phalanges (Ra)mentioning

confidence: 99%

“…Among these techniques, phalangeal ultrasound [18], computed digital absorptiometry [19,20] and radiographic absorptiometry (RA) [21,22,23,24,25,26,27,28] have documented reasonable sensitivity and specificity, which were, however, not sufficiently good to replace DXA for the diagnosis of osteoporosis. Recently, we addressed the question of whether and how well radiographic absorptiometry of the phalanges predicted osteoporosis at the spine or hip (as diagnosed by DXA) and whether a two-step diagnostic strategy (using RA as the first line to identify patients with low bone mass and DXA as the second line to assess the diagnosis of osteoporosis and take the treatment decision) was cost-effective in postmenopausal women [25].…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis case finding in the general practice: phalangeal radiographic absorptiometry with and without risk factors for osteoporosis to select postmenopausal women eligible for lumbar spine and hip densitometry

et al. 2005

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Mass screening for osteoporosis using DXA measurements at the spine and hip is presently not recommended by health authorities. Instead, risk factor questionnaires and peripheral bone measurements may facilitate the selection of women eligible for axial bone densitometry. The aim of this study was to validate a case finding strategy for postmenopausal women who would benefit most from subsequent DXA measurement by using phalangeal radiographic absorptiometry (RA) alone or in combination with risk factors in a general practice setting. The sensitivity and specificity of this strategy in detecting osteoporosis (T-score £ 2.5 SD at the spine and/or the hip) were compared with those of the current reimbursement criteria for DXA measurements in Switzerland. Four hundred and twenty-three postmenopausal women with one or more risk factors for osteoporosis were recruited by 90 primary care physicians who also performed the phalangeal RA measurements. All women underwent subsequent DXA measurement of the spine and the hip at the Osteoporosis Policlinic of the University Hospital of Berne. They were allocated to one of two groups depending on whether they matched with the Swiss reimbursement conditions for DXA measurement or not. Logistic regression models were used to predict the likelihood of osteoporosis versus ''no osteoporosis'' and to derive ROC curves for the various strategies. Differences in the areas under the ROC curves (AUC) were tested for significance. In women lacking reimbursement criteria, RA achieved a significantly larger AUC (0.81; 95% CI 0.72-0.89) than the risk factors associated with patients' age, height and weight (0.71; 95% C.I. 0.62-0.80). Furthermore, in this study, RA provided a better sensitivity and specificity in identifying women with underlying osteoporosis than the currently accepted criteria for reimbursement of DXA measurement. In the Swiss environment, RA is a valid case finding tool for patients with risk factors for osteoporosis, especially for those who do not qualify for DXA reimbursement.

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Radiographic absorptiometry: A simple method for determination of bone mass

Cited by 114 publications

References 10 publications

Current methods and recent advances in the diagnosis of osteoporosis

Current methods and recent advances in the diagnosis of osteoporosis

Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia

Osteoporosis case finding in the general practice: phalangeal radiographic absorptiometry with and without risk factors for osteoporosis to select postmenopausal women eligible for lumbar spine and hip densitometry

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