Scanning both Hips and the Lumbar Vertebrae in Men Identifies More Patients with Osteoporosis than Scanning One Hip and the Lumbar Vertebrae

Abstract

Background: In the absence of fragility fractures, the diagnosis of osteoporosis is established by bone densitometry: a T-score of -2.5 or lower in the femoral neck, total hip or lumbar vertebrae. One hip and the lumbar vertebrae are routinely scanned, and there is no consensus which hip should be used. The purpose of this retrospective study is to determine whether, in a male population, scanning both hips and the lumbar vertebrae identifies more patients with osteoporosis than scanning only one hip and the lumbar vertebrae. Methods:We retrieved data from 1,048 male Caucasian patients referred to our Center who were not on treatment for osteoporosis, had no documented bone pathology and had interpretable scans of both hips and the lumbar vertebrae.Results: More men aged 80 years and older were diagnosed with osteoporosis when scans of both hips and the lumbar vertebrae were considered, compared to the left hip and lumbar vertebrae (7%) or right hip and lumbar vertebrae (6%). The differences in diagnostic categories were less pronounced in younger subjects: only 2% more men younger than 60 years were diagnosed with osteoporosis when both hips and the lumbar vertebrae were scanned compared to just one hip and the lumbar vertebrae. Conclusions:We recommend that in Caucasian men, especially those aged 80 years and older, both hips be scanned in addition to the lumbar vertebrae.