The role of DXA bone density scans in the diagnosis and treatment of osteoporosis

Blake, Glen M.; Fogelman, Ignac

doi:10.1136/pgmj.2007.057505

Cited by 383 publications

(253 citation statements)

References 72 publications

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“…Peripheral BMD measurements with non-DXA techniques at the heel, forearm or hand are performed less commonly and their results correlate only poorly with central DXA 19 . The power of BMD to predict fracture risk at different sites, however, is improved by site-specific measurements, and hip or spine BMD predict forearm fracture risk less well than peripheral BMD 20,21 . This is consistent with our findings that the predictive power of BMD measurements conducted by hip and spine DXA was inconclusive in predicting distal forearm fractures.…”

Section: Discussionmentioning

confidence: 99%

“…The age distribution of women in the general population is based on the proportion of women in the respective age predict any osteoporotic fracture equally well, with a gradient of risk of approximately 1.5 per standard deviation decrease in BMD 21 . In younger patients, the power of DXA to predict forearm fractures or to serve as therapeutic threshold seems generally to be limited as shown in the literature 20,22 . BMD measurements therefore need to be complemented with CRF associated with fracture risk, such as age, sex, prior fractures, use of corticosteroids and other high-risk medications, low body mass index, biochemical markers of bone resorption and certain diseases associated with osteoporosis 21 .…”

Section: Discussionmentioning

confidence: 99%

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Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian Menopause and Osteoporosis Clinic

Boschitsch¹,

Durchschlag²,

Dimai

2017

Climacteric

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Objectives: Age and bone mineral density (BMD) are the most relevant determinants for public health authorities to govern the management of osteoporosis. The objectives of this study were to determine the age-related prevalence of osteopenia and osteoporosis according to WHO criteria and fragility fractures in middle-aged and older women. Methods: Women 40 years, who were referred to a menopause and osteoporosis outpatient clinic for BMD measurements, were assessed for patient characteristics, BMD and previous fragility fractures of the hip, the distal forearm and the vertebrae. Only records of their initial consultations were used for data analysis. Results: Between 1990 and 2012, 99,399 women, mean age 56.1 years, were referred to the clinic for BMD testing. Of the total population, 52.5% showed normal, 34.0% osteopenic and 13.5% osteoporotic BMD. Fragility fractures were reported by 6540 patients, with 3070 (47%) non-vertebral fractures, namely 2518 (38.5%) distal forearm and 552 (8.4%) hip fractures; 66.8% of patients with the non-vertebral fractures were <65 years. Conclusion: The prevalence of osteoporosis and fragility fractures in middle-aged women, < 65 years, is hitherto under-recognized. Measuring BMD alone is not sufficient to identify patients at risk for fractures. Supplemental screening for clinical risk factors already during perimenopause may be advantageous. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian Menopause and Osteoporosis Clinic

Boschitsch¹,

Durchschlag²,

Dimai

2017

Climacteric

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“…Di Indonesia, DEXA pada umumnya tidak terdapat di rumah sakit kecil di daerah atau puskesmas, melainkan hanya terdapat di rumah sakit rujukan atau rumah sakit besar. 4,5 Di antara masalah yang banyak dialami oleh lansia adalah permasalahan pada gigi dan mulut. Hal ini mengakibatkan potensi lansia untuk mengunjungi dokter gigi cukup tinggi.…”

Section: Pendahuluanunclassified

Hubungan fraksi area trabekula anterior mandibula dengan kepadatan tulang lumbar spine untuk deteksi dini osteoporosis

Lestari

Widyaningrum

2017

Majalah Kedokteran Gigi Indonesia

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ABSTRAKKepadatan tulang merupakan indikator osteoporosis, salah satu diantaranya adalah kepadatan tulang pada lumbar spine. Penurunan kepadatan tulang pada lumbar spine mempengaruhi kondisi tulang lain, termasuk tulang rahang bawah (mandibula). Tujuan penelitian ini adalah untuk menentukan prediktor densitas mineral tulang menggunakan citra radiograf periapikal tulang trabekula pada regio anterior rahang bawah. Penelitian dilakukan dengan ekstraksi fraksi area tulang trabekula mandibula yang tercitrakan pada radiograf periapikal digital dari 25 subjek. Pengolahan citra digital pada radiograf periapikal dilakukan dengan menggunakan metode deteksi tepi canny terhadap masing-masing citra radiograf. Region of Interest diseleksi dari citra hasil deteksi canny, sehingga dapat dilakukan pengukuran fraksi area. Uji regresi linier dilakukan untuk mengetahui hubungan antara nilai fraksi area trabekula mandibula dengan tingkat kepadatan tulang pada lumbar spine. Hasil uji regresi linier menunjukkan bahwa nilai fraksi area trabekula mandibula berkorelasi negatif dengan kepadatan tulang dengan kekuatan sedang (α = 0,046; R = -0,403). Adapun arah korelasi antara nilai fraksi area trabekula mandibula dengan kepadatan tulang adalah negatif (b = -0,145). Fraksi area tulang trabekula pada citra radiograf periapikal dapat digunakan sebagai prediktor kepadatan tulang pada lumbar spine. PENDAHULUANOsteoporosis adalah suatu penyakit skeletal sistemik yang dicirikan dengan penurunan massa tulang, perubahan arsitektur tulang, dan konsekuensi klinis berupa kerentanan terhadap fraktur (patah tulang) akibat trauma yang ringan ataupun tanpa trauma. Pada umumnya, fraktur terjadi pada bagian tulang yang mayoritas tersusun oleh trabekula, antara lain pergelangan tangan (wrist), tulang belakang (spine), dan pangkal paha (hip). Kontribusi osteoporosis terhadap angka kesakitan (morbiditas) dan angka kematian (mortalitas) relatif rendah. Namun demikian fraktur osteoporosis membuat penderitanya kesakitan serta mempengaruhi kondisi sosial ekonomi akibat perubahan aktivitas sosial kemasyarakatan dan beban biaya pengobatan bagi penderita dan keluarganya.

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“…3 Introduction Central dual energy x-ray absorptiometry (DXA) of the spine and hip is the current preferred method for the diagnosis of osteoporosis [1]. DXA scanners have good long term precision due to stable calibration and effective instrument quality control procedures to detect long term drift [1].…”

Section: Introductionmentioning

confidence: 99%

“…DXA scanners have good long term precision due to stable calibration and effective instrument quality control procedures to detect long term drift [1]. However, the results from DXA scanners produced by different manufacturers and even the same make of scanner made by the same manufacturer cannot be directly compared due to potential differences in calibration [2].…”

Section: Introductionmentioning

confidence: 99%

Static and mobile DXA scanner in-vivo cross-calibration study

2013

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Cross calibration of DXA scanning equipment with phantom subjects has been recommended for assessing agreement between devices co-located within DXA scanning services.This study evaluated in-vivo and in-vitro cross calibration of a static and a mobile DXA scanner within the same service in their individual clinical settings. 50 individuals from a volunteer group were recruited to take part in this study and had DXA measurements made on two GE Lunar Prodigy Advance (GE Lunar, Bedford, UK) scanners.Results in this study showed that the scanners agreed, with no statistically significant differences in BMD measurements made at the same site on the individual devices used in this study. The in-vivo cross calibration of the instruments was a useful experience, which demonstrated closely calibrated systems and raised the profile of the bone densitometry service within the hospital.3 Introduction Central dual energy x-ray absorptiometry (DXA) of the spine and hip is the current preferred method for the diagnosis of osteoporosis [1]. DXA scanners have good long term precision due to stable calibration and effective instrument quality control procedures to detect long term drift [1]. However, the results from DXA scanners produced by different manufacturers and even the same make of scanner made by the same manufacturer cannot be directly compared due to potential differences in calibration [2]. When introducing additional or replacing DXA scanners it is therefore recommended to perform cross calibration whether the new machine is from the same manufacturer or not [3]. While cross calibration between two machines of the same manufacturer and using the same manufacture's phantom has been reported to have good agreement of 0.2%, in vivo measurements may differ by more than 2%[4] The increased errors in-vivo can be partly attributed to the increased precision errors introduced by virtue of scanning an individual who has in-homogeneity within their tissue, meaning that the x-ray photons may not pass though the same structures on both scans. Precision errors within DXA are also important for the characterisation of it's ability to assess bone mineral density and detect longitudinal change. Monitoring measurement errors within a service is also dependant on QA systems to detect scanner changes [5]. When introducing a new scanner, it is recommended to undertake a cross-calibration of the scanners within a service. The optimum technique for undertaking a cross-calibration study of DXA scanners is to use in-vivo measurements since this is how DXA scanners are used in clinical practice [4,6].In 2009, a GE Lunar Prodigy DXA scanner (GE Healthcare, Bedford, UK) was purchased and commissioned to operate in a mobile vehicle, alongside the existing static GE Lunar Prodigy within the Healthy Bones Service at Derriford Hospital (Plymouth UK). While it is not good practice to make longitudinal measurements of

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The role of DXA bone density scans in the diagnosis and treatment of osteoporosis

Cited by 383 publications

References 72 publications

Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian Menopause and Osteoporosis Clinic

Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian Menopause and Osteoporosis Clinic

Hubungan fraksi area trabekula anterior mandibula dengan kepadatan tulang lumbar spine untuk deteksi dini osteoporosis

Static and mobile DXA scanner in-vivo cross-calibration study

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