Fehlermöglichkeiten und Interpretationsprobleme der Osteodensitometrie

Abstract

The clinical relevance of osteoporosis as a frequent systemic skeletal disease is to be found in fractures and their consequences. For prevention of these disease manifestations great importance must be attached to a safest possible diagnosis even before the occurrence of the first fracture and osteodensitometry is a well established technique for this purpose. Among the different measurement procedures DXA (dual-energy X-ray absorptiometry) has become the gold standard worldwide. This method is seen as very reliable and adequately precise. Prerequisites for these characteristics are the correct interpretation of the measurement data obtained by taking into consideration all potential influencing factors which can either false positively or false negatively influence a single value as well as the calculated mean value and the T and Z scores. Thus, exact knowledge of potential sources of error is of crucial importance. The present study shows important sources of error and difficulties in interpretation as well as a discussion of the options for their prevention. For the clinical practice osteodensitometry is to be seen as an important diagnostic component, which can only been interpreted meaningfully with respect to the clinical data.

Pediatric and adult osteoporosis: a contrasting mirror

“…DXA should be cautiously interpreted, taking into consideration all potential factors that could either falsely elevate or diminish bone density [ 23 ]. Scholz et al [ 24 ] identified potential sources of error and risks in the interpretation of bone densitometry. In a study on the prevalence of DXA interpretation errors, technical errors were identified in 90% of patients and 42% were major errors (defined as incorrect information that could potentially lead to inappropriate care decisions for the patient) [ 25 ].…”

“…Because DXA measures BMD in a 2-dimensional image, volumetric BMD (g/cm3) is underestimated in short-stature children and overestimated in tall children. Errors in DXA measurements are also common in adults and can be categorized as patient positioning, data analysis, artifacts, and/or demographics [ 24 ].…”

“…Errors in DXA measurements are also common in adults and can be categorized as patient positioning, data analysis, artifacts, and/or demographics. 24)…”

Welche Bedeutung hat die Knochendichte in der Hüftendoprothetik?

“…Die Knochendichte ist einer der wichtigsten Parameter zur Erfassung möglicher struktureller Veränderungen innerhalb des Knochens und daher auch obligater Bestandteil der Diagnostik und Verlaufskontrolle der Osteoporose (13). Verschiedene Studien zeigten einen negativen Zusammenhang zwischen einer verminderten Knochendichte der Hüfte und der Lang -lebigkeit verschiedener Hüftendoprothesentypen (14)(15)(16).…”