Precision of dual-energy X-ray absorptiometry of the knee and heel: methodology and implications for research to reduce bone mineral loss after spinal cord injury

Abstract

For DXA-based estimates of BMD at the distal femur, proximal tibia and calcaneus, these precision values suggest that LSC values >10% are needed to detect differences between treated and untreated groups in studies aimed at reducing bone mineral loss after SCI.

Musculoskeletal Outcomes from Chronic High-Speed, High-Impulse Resistance Exercise

“…Thus we believe our calcaneal BMC and BMD values are appropriate given the subject's body posture. Yet a recent study, with calcaneal BMD measurements carried out in a similar body posture, produced far higher calcaneal values in spinal cord-injured subjects [41]. Differences in calcaneal BMD between the current and Peppler studies were likely due to disparities in the densitometers and gender composition.…”

“…The calcaneus has the most trabecular bone ( > 95 %) of the human body [41]. Since it is also a weight-bearing bone, it is quite responsive to mechanical stimuli [41]. In turn, the degree to which our most highly responsive subjects adapted to our novel exercise stimulus contributed to our left calcaneal BMC and BMD gains shown in ▶ Table 4, 5, and the considerable variability shown in ▶Fig.…”

“…It is of interest to speculate on the degree of BMD accretion by Hamaguchi et al had it entailed a similar training volume as our study. The calcaneus has the most trabecular bone ( > 95 %) of the human body [41]. Since it is also a weight-bearing bone, it is quite responsive to mechanical stimuli [41].…”

“…Differences in calcaneal BMD between the current and Peppler studies were likely due to disparities in the densitometers and gender composition. With adult subjects, Peppler et al used a densitometer intended for pediatric populations [41]. Since adults usually have higher BMD values than children, when the former are scanned on pediatric densitometers and/or software they may yield inflated results.…”

Anticonvulsant Use and Bone Health in a Population-based Study of Men and Women: Cross-sectional Data from the Geelong Osteoporosis Study.

“…Dual energy X-ray absorptiometry (DXA) measures bone mineral density (BMD), and is currently the key assessment tool for diagnosing osteoporosis [6]. However, being a 2-dimensional measure, BMD does not su ciently explain variance in fracture outcomes amongst individuals with similar BMD measures [7][8][9], thus additional bone measures may be useful. Quantitative heel ultrasound (QUS) is a radiation-free, portable, non-invasive, inexpensive screening method to assess bone quality [6], measuring 3dimensional parameters such as bone structure and elasticity to explain variance in bone strength [10,11].…”