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1-5 Bone Densitometr1- Dr. Omar Hussien

1-5 Bone Densitometr1- Dr. Omar Hussien

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Published by: tarikeops on Feb 26, 2010
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05/25/2012

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Bone densitometry:The ideal detector for Osteoporosis
By Dr Omar Hussein
Professor of Radiodiagnosis
 
Osteoporosis
is a disease characterized by:
 – 
Low bone mass
 – 
Microarchitectural deterioration of the bone leading to Hip,Colle’s, and vertebral fractures
 – 
Microarchitectural Changes in Osteoporosis includedecreased Bone Mass,Trabecular Thickness, Trabecular Number, HorizontalStruts and Connectivity
 – 
It is worth saying that Bone Resorption takes 7-10 days tohappen , while Bone formation takes 10-12 weeks
BMD Testing Techniques
 
A. Traditional methods
Conventional radiography
Radiographic absorptiometry (RA)
Ultrasound densitometry
Dual-energy X-ray absorptiometry(DEXA) 
B. Non traditional methods
New DEXA techniques
Quantitative computed tomography (QCT) and Finite ElementAnalysis
MRI
1
 
 
The Basics of BMD Measurement
Measurement of BMD at any skeletal site has a value in predictingfracture risk. A variety of densitometers are in clinical use andprovide reliable assessment of fracture risk.However, hip BMD is the best predictor of hip fractures, andspine BMD is the best predictor of spine fractures.
Dual energy X-ray Absorptiometry DXA
Better than Isotope-based absorptiometry
X-ray based
Excellent precision and accuracy (1%)
Reliable and versatile
Economic exam cost
High-intensity beam
Fast scans, low dose
High image quality
Can measure all skeletal sites: central and peripheral 
Best Clinical Utility
Clinical uses:
Site - specific measurements, essential for prediction of BMD,fracture risk rate of loss.
Comprehensive evaluation:
Lumbar spine
Proximal femur
 Total body is important in children, metabolic bone disease,severe osteoporosis.
2
 
DEXA allows us to determine :
A-Bone Tissue
BMD (g/m²)
Bone Mass (g)
Area
A-Soft Tissue
%Fat (R Value)
Soft Tissue Mass (g) ( Fat Free Mass)
Fat Mass (g)
Lean Mass (g) (Fat free and Bone free Mass)
Problems in the interpretation of BMD by DEXA:
Osteomalacia
Osteoarthritis (especially the spine)
Vascular calcification (especially the spine)
Overlying metal objects
Contrast media (spine)
Previous fracture (spine, hip and wrist)
Severe scoliosis
Vertebral deformities due to osteoarthrosis, Scheuermann`sdisease
Who should be tested?
1. All postmenopausal women under age 65 who have one ormore additional risk factor for osteoporosis.2. All women aged 65 and older regardless of additional riskfactors.3. Postmenopausal women who present with fractures (toconfirm diagnosis and determine disease severity)4. Women who are considering therapy for osteoporosis, if BMDtesting would facilitate the decision.
3

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