The Role of DXA Bone Density Scans in the Diagnosis and Treatment of Osteoporosis

Overview

Journal Postgrad Med J

Publisher Oxford University Press

Specialty General Medicine

Date 2007 Aug 7

PMID 17675543

Citations 168

Authors

Glen M Blake

Ignac Fogelman

Affiliations

Soon will be listed here.

Abstract

Dual energy x ray absorptiometry (DXA) scans to measure bone mineral density (BMD) at the spine and hip have an important role in the evaluation of individuals at risk of osteoporosis, and in helping clinicians advise patients about the appropriate use of antifracture treatment. Compared with alternative bone densitometry techniques, hip and spine DXA examinations have a number of advantages that include a consensus that BMD results can be interpreted using the World Health Organization T-score definition of osteoporosis, a proven ability to predict fracture risk, proven effectiveness at targeting antifracture therapies, and the ability to monitor response to treatment. This review discusses the evidence for these and other clinical aspects of DXA scanning, including its role in the new WHO algorithm for treating patients on the basis of their individual fracture risk.

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References

Patel R, Blake G, Rymer J, Fogelman I . Long-term precision of DXA scanning assessed over seven years in forty postmenopausal women. Osteoporos Int. 2000; 11(1):68-75. DOI: 10.1007/s001980050008. View

Cummings S, Black D, Nevitt M, Browner W, Cauley J, Ensrud K . Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet. 1993; 341(8837):72-5. DOI: 10.1016/0140-6736(93)92555-8. View

Blake G, Herd R, Fogelman I . A longitudinal study of supine lateral DXA of the lumbar spine: a comparison with posteroanterior spine, hip and total-body DXA. Osteoporos Int. 1996; 6(6):462-70. DOI: 10.1007/BF01629579. View

Kanis J, Oden A, Johnell O, Jonsson B, De Laet C, Dawson A . The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001; 12(5):417-27. DOI: 10.1007/s001980170112. View

Kanis J, Delmas P, Burckhardt P, Cooper C, Torgerson D . Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int. 1997; 7(4):390-406. DOI: 10.1007/BF01623782. View

Center J, Nguyen T, Schneider D, Sambrook P, Eisman J . Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999; 353(9156):878-82. DOI: 10.1016/S0140-6736(98)09075-8. View

Ettinger B, Black D, Mitlak B, Knickerbocker R, Nickelsen T, Genant H . Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999; 282(7):637-45. DOI: 10.1001/jama.282.7.637. View

Pluijm S, Graafmans W, Bouter L, Lips P . Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. Osteoporos Int. 2000; 9(6):550-6. DOI: 10.1007/s001980050275. View

Kanis J, Johansson H, Oden A, Johnell O, De Laet C, Eisman J . A family history of fracture and fracture risk: a meta-analysis. Bone. 2004; 35(5):1029-37. DOI: 10.1016/j.bone.2004.06.017. View

10.

Kanis J . Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002; 359(9321):1929-36. DOI: 10.1016/S0140-6736(02)08761-5. View

11.

Kanis J, Johansson H, Johnell O, Oden A, De Laet C, Eisman J . Alcohol intake as a risk factor for fracture. Osteoporos Int. 2004; 16(7):737-42. DOI: 10.1007/s00198-004-1734-y. View

12.

Eastell R . Treatment of postmenopausal osteoporosis. N Engl J Med. 1998; 338(11):736-46. DOI: 10.1056/NEJM199803123381107. View

13.

Borgstrom F, Johnell O, Kanis J, Jonsson B, Rehnberg C . At what hip fracture risk is it cost-effective to treat? International intervention thresholds for the treatment of osteoporosis. Osteoporos Int. 2006; 17(10):1459-71. DOI: 10.1007/s00198-006-0107-0. View

14.

Chesnut 3rd C, Skag A, Christiansen C, Recker R, Stakkestad J, Hoiseth A . Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004; 19(8):1241-9. DOI: 10.1359/JBMR.040325. View

15.

Lu Y, Genant H, Shepherd J, Zhao S, Mathur A, Fuerst T . Classification of osteoporosis based on bone mineral densities. J Bone Miner Res. 2001; 16(5):901-10. DOI: 10.1359/jbmr.2001.16.5.901. View

16.

Blake G, Fogelman I . Peripheral or central densitometry: does it matter which technique we use?. J Clin Densitom. 2001; 4(2):83-96. DOI: 10.1385/jcd:4:2:083. View

17.

Cummings S, Melton L . Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002; 359(9319):1761-7. DOI: 10.1016/S0140-6736(02)08657-9. View

18.

De Laet C, Oden A, Johansson H, Johnell O, Jonsson B, Kanis J . The impact of the use of multiple risk indicators for fracture on case-finding strategies: a mathematical approach. Osteoporos Int. 2004; 16(3):313-8. DOI: 10.1007/s00198-004-1689-z. View

19.

Harris S, Watts N, Genant H, McKeever C, Hangartner T, Keller M . Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999; 282(14):1344-52. DOI: 10.1001/jama.282.14.1344. View

20.

Stone K, Seeley D, Lui L, Cauley J, Ensrud K, Browner W . BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res. 2003; 18(11):1947-54. DOI: 10.1359/jbmr.2003.18.11.1947. View