Dual Hip DXA. Is it Time to Change Standard Protocol?
| Autor: | Weiwen Chen, Zulekha Khan, Nicholas Pocock, Judith Freund |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
musculoskeletal diseases
Lumbar Vertebrae Femur Neck business.industry Endocrinology Diabetes and Metabolism Osteoporosis Total hip replacement Retrospective cohort study Standard score musculoskeletal system medicine.disease Absorptiometry Photon medicine.anatomical_structure Bone Density Hip bone medicine Standard protocol Humans Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine Lumbar spine business Nuclear medicine Retrospective Studies Femoral neck |
| Zdroj: | Journal of Clinical Densitometry. 25:20-23 |
| ISSN: | 1094-6950 |
| DOI: | 10.1016/j.jocd.2021.07.006 |
| Popis: | Previous studies have examined the utility of bilateral DXA hip bone mineral density (BMD) scans. While most studies demonstrate an advantage of bilateral hip scanning, the studies have been limited by size, or have not included simultaneous lumbar spine scans. To analyse the utility of dual hip scans in a clinical environment, a large retrospective study was performed of DXA BMD of both hips, and lumbar spine, in 17,169 individuals assessed at one centre over 10 years. There was no clinically significant difference in the population mean femoral neck BMD of the left vs the right leg (0.878 vs 0.881g/cm2) or total proximal femoral BMD of the left vs the right leg (0.920 vs 0.919g/cm2). There were however discrepancies in individuals between hip t-scores. For the total hip 1,977 (11.5 %) and 147 (0.9 %) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. For the femoral neck 3,320 (19.3%) and 337 (2.0%) of subjects had absolute t score differences ≥ 0.50 or ≥ 1.00. respectively. Of the total 17,169 individuals there were 2,776 subjects with osteoporosis (T≤ -2.5) using the lumbar spine and right hip, compared to 2,834 subjects using the lumbar spine and left hip. Using the lumbar spine and both hips identified 3,214 individuals with osteoporosis. Diagnosis based on use of the lumbar spine and right hip BMD, or lumbar spine and left hip BMD, therefore failed to identify 15.8%, or 13.4%, of osteoporotic subjects respectively. Additional scanning time required was assessed in 40 subjects prospectively. Performing lumbar spine and both hips, compared to lumbar spine and one hip, required an average additional scan time of 55 seconds. The recommendation of best practise for DXA BMD measurements should be reviewed to consider lumbar spine and dual hip DXA as standard of care. |
| Databáze: | OpenAIRE |
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