Dual-energy X-ray Absorptiometry

Jain, Rajesh; Vokes, Tamara

doi:10.1016/j.jocd.2017.06.014

Cited by 93 publications

(69 citation statements)

References 86 publications

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“…BMD results obtained by DXA are usually expressed as T-score or Z-score. T-score represents the number of standard deviations by which BMD varies from the mean value expected in a young healthy subject (20-30 years of age), whereas Z-score is the number of standard deviations by which BMD varies from the mean value typical for a person with the same age and sex (1,24). According to the World Health Organization (WHO) definition of osteoporosis, the disease can be diagnosed when T-score ≤−2.5 of DXA at the lumbar spine, femoral neck or distal third of the radius (25,26).…”

Section: Diagnosing Osteoporosis With Dxamentioning

confidence: 99%

“…Hip geometry obtained by two-dimensional DXA scans offers the possibility to evaluate several parameters, such as the proximal hip axis length (HAL), cross-sectional moment of inertia, the neck shaft angle and the cross-sectional area (see Figure 3). These measurements showed to correlate with three-dimensional parameters obtained with QCT (34); nevertheless, due to the weak association with fractures when controlling for BMD, a lack of consensus about the clinical use of hip geometry parameter (24,35). As a consequence, a recent position paper by the ISCD was issued in 2015 providing recommendations about hip geometry possible use for fracture risk prediction (36).…”

Section: Additional Tools Of Dxamentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic imaging of osteoporosis and sarcopenia: a narrative review

Messina

Maffi

Vitale

et al. 2018

Quant. Imaging Med. Surg.

107

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Osteoporosis and sarcopenia represent two major health problems with an increasing prevalence in the elderly population. The correlation between these diseases has been widely reported, leading to the development of the term "osteosarcopenia" to diagnose those patients suffering from both diseases. Several imaging methods for the diagnosis and management of osteoporosis exist, with dual-energy X-ray absorptiometry (DXA) being the most commonly used for measuring bone mineral density (BMD). Imaging technique other than DXA is represented by conventional radiography, computed tomography (CT) and ultrasound (US). Similarly, the imaging technologies used to detect loss of skeletal muscle mass in sarcopenia include DXA, CT, US and magnetic resonance imaging (MRI). These methods differ in terms of reliability, radiation exposure and costs. CT and MRI represent the gold standard for evaluating body composition (BC), but are costly and time-consuming. DXA remains the most often used technology for studying BC, being quick, widely available and with low radiation exposure.

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Section: Diagnosing Osteoporosis With Dxamentioning

confidence: 99%

Section: Additional Tools Of Dxamentioning

confidence: 99%

Diagnostic imaging of osteoporosis and sarcopenia: a narrative review

Messina

Maffi

Vitale

et al. 2018

Quant. Imaging Med. Surg.

107

View full text Add to dashboard Cite

show abstract

“…Assessing bone mineral density (BMD) by means of dual X-ray absorptiometry (DXA) is well established and standard of care for evaluating fracture risk in osteoporosis [13,14] but only few studies with small case numbers provide data on BMD in adult patients with HPP [4,6,8,15,16]. Reported findings are heterogeneous and have not been associated with fracture pattern or prevalence, yet.…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and fracture risk in adult patients with hypophosphatasia

et al. 2020

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In adult hypophosphatasia (HPP) patients, elevated lumbar spine dual X-ray absorptiometry (DXA) values are associated with markers of disease severity and disease-specific fracture risk while femoral bone mineral density (BMD), being largely unaffected by the disease severity, may still be useful to monitor other causes of increased fracture risk due to low BMD. Introduction Hypophosphatasia (HPP) is a rare inherited metabolic disorder due to deficient activity of the tissue-nonspecific alkaline phosphatase (TNAP). Clinical manifestation in adult HPP patients is manifold including an increased risk for fractures, but data regarding clinical significance of DXA measurement and associations with fracture risk and disease severity is scarce. Methods Retrospective single-center analysis of DXA scans in patients with confirmed HPP (documented mutation, clinical symptoms, low alkaline phosphatase activity). Further data evaluation included disease-related fractures, laboratory results (alkaline phosphatase, pyridoxalphosphate, phosphoethanolamine), and medical history. Results Analysis included 110 patients (84 female, mean age of 46.2 years) of whom 37.3% (n = 41) were harboring two mutations. Average T-Score level at the lumbar spine was − 0.1 (SD 1.9), and mean total hip T-Score was − 1.07 (SD 0.15). Both lower ALP activity and higher substrate levels (pyridoxalphosphate and phosphoethanolamine) were significantly correlated with increased lumbar spine T-Score levels (p < 0.001) while BMD at the hip was not affected by indicators of disease severity. Increased lumbar spine BMD was significantly associated with an increased risk for HPP-related fractures, prevalent in 22 (20%) patients (p < 0.001) with 21 of them having biallelic mutations. Conclusion BMD in adult HPP patients is not systematically reduced. Conversely, increased lumbar spine BMD appears to be associated with severely compromised mineralization and increased risk for HPP-related fractures while BMD at the hip appears unaffected by indicators of disease severity, suggesting suitability of this anatomic location for assessing and discerning disorders with increased fracture risk owing to reduced BMD like osteoporosis. Trial registration number German register for clinical studies (DRKS00014022) Date of registration 02/10/2018retrospectively registered

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“…According to the WHO classification, patients with a T-score of ≤−2.5 were accepted as osteoporotic, those with scores of −1 to −2.5 as osteopenic and those with a score of >−1 as normal. [ 14 ] Patients were excluded if they had previously received pharmacological treatment for osteoporosis.…”

Section: Methodsmentioning

confidence: 99%

Agreement between the Turkey Guidelines and the Fracture Risk Assessment Tool®-based Intervention Threshold

2018

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BackgroundThe aim of this study was to evaluate the agreement between the fracture-risk assessment tool (FRAX®)-based intervention strategy in Turkey and the recommendations published in the Healthcare Practices Statement (HPS).MethodsThis descriptive cross-sectional study included individuals aged 40 to 90 years who were previously diagnosed as having osteoporosis but had not received any treatment. The intervention thresholds recommended by the National Osteoporosis Foundation for treatment were used. The criteria necessary for the start of administration of pharmacological agents in osteoporosis treatment were evaluated on the basis of the HPS guidelines.ResultsOf the 1,255 patients evaluated, 161 (12.8%) were male and 1,094 (87.2%) were female. In the evaluation, according to HPS, treatment was recommended for 783 patients (62.4%; HPS+) and not recommended for 472 (37.6%; HPS−). Of the 783 HPS+ patients, 391 (49.9%) were FRAX+, and of the 472 HPS− patients, 449 (95.1%) were FRAX−. A statistically significant difference was observed between the treatment recommendations of HPS and FRAX® (P<0.001). In the age group of 75 to 90 years, excellent agreement was found between the two strategies (Gwet's agreement coefficient 1=0.94). As age increased, the agreement between the two treatment strategies also increased.ConclusionsThe FRAX® model has different treatment recommendation rates from the HPS. The agreement between the two is at a minimal level. However, as age increased, so did the agreement between the FRAX® and the HPS treatment recommendations. In the recommendation to start pharmacological treatment primarily based on age, non-medical interventions that preserve bone density should be evaluated.

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Dual-energy X-ray Absorptiometry

Cited by 93 publications

References 86 publications

Diagnostic imaging of osteoporosis and sarcopenia: a narrative review

Diagnostic imaging of osteoporosis and sarcopenia: a narrative review

Bone mineral density and fracture risk in adult patients with hypophosphatasia

Agreement between the Turkey Guidelines and the Fracture Risk Assessment Tool®-based Intervention Threshold

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