Radiographic absorptiometry for pre-screening of osteoporosis in patients with low energy fractures
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Radiographic absorptiometry for pre-screening of osteoporosis in patients with low energy fractures. / Buch, Inge; Oturai, Peter S; Jensen, Lars T.
In: Scandinavian Journal of Clinical and Laboratory Investigation. Supplement, Vol. 70, No. 4, 07.2010, p. 269-74.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Radiographic absorptiometry for pre-screening of osteoporosis in patients with low energy fractures
AU - Buch, Inge
AU - Oturai, Peter S
AU - Jensen, Lars T
PY - 2010/7
Y1 - 2010/7
N2 - Dual energy X-ray absorptiometry (DEXA) is the most accurate method and thus the method of choice for diagnosing osteoporosis. Due to the limited access to DEXA-scanners, screening of patients with low energy fractures (LEF) for osteoporosis is not routinely performed in Denmark. Pre-screening with a simple, less expensive device might be able to exclude patients with normal bone mineral density (BMD) from further DEXA-scans. We aimed to determine the frequency of osteoporosis in patients with LEF, and evaluate the diagnostic impact of a radiographic absorptiometry (RA) scanner in the casualty department of a major Danish county hospital. In a 5-month period, 136 adult patients with LEF were invited for BMD measurements. In 74 (54%) patients DEXA-scans (spine and femoral neck) and phalangeal RA-scans were performed. A total of 86% of the patients were female and 39% were suffering from osteoporosis (T-scores < or = -2.5) according to the DEXA results. RA-BMD and T-scores differed significantly between the two groups, with and without osteoporosis (p < 0.001). Comparing T-scores from RA with the lowest T-scores from DEXA, a highly significant correlation was found for women (R = 0.7, p < 0.001). Using a RA cut-off value (T-score < -1) for women ensuring 100% sensitivity for identifying women with osteoporosis, the positive predictive value was 46%. Up to 19% of DEXA-scans could be avoided in this setting. In our population the simple RA-BMD-method was cost-effective as a pre-screening tool for osteoporosis in women. However, the final diagnosis still relies on results from DEXA-scans.
AB - Dual energy X-ray absorptiometry (DEXA) is the most accurate method and thus the method of choice for diagnosing osteoporosis. Due to the limited access to DEXA-scanners, screening of patients with low energy fractures (LEF) for osteoporosis is not routinely performed in Denmark. Pre-screening with a simple, less expensive device might be able to exclude patients with normal bone mineral density (BMD) from further DEXA-scans. We aimed to determine the frequency of osteoporosis in patients with LEF, and evaluate the diagnostic impact of a radiographic absorptiometry (RA) scanner in the casualty department of a major Danish county hospital. In a 5-month period, 136 adult patients with LEF were invited for BMD measurements. In 74 (54%) patients DEXA-scans (spine and femoral neck) and phalangeal RA-scans were performed. A total of 86% of the patients were female and 39% were suffering from osteoporosis (T-scores < or = -2.5) according to the DEXA results. RA-BMD and T-scores differed significantly between the two groups, with and without osteoporosis (p < 0.001). Comparing T-scores from RA with the lowest T-scores from DEXA, a highly significant correlation was found for women (R = 0.7, p < 0.001). Using a RA cut-off value (T-score < -1) for women ensuring 100% sensitivity for identifying women with osteoporosis, the positive predictive value was 46%. Up to 19% of DEXA-scans could be avoided in this setting. In our population the simple RA-BMD-method was cost-effective as a pre-screening tool for osteoporosis in women. However, the final diagnosis still relies on results from DEXA-scans.
KW - Absorptiometry, Photon
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Fractures, Bone
KW - Humans
KW - Male
KW - Middle Aged
KW - Osteoporosis
KW - Young Adult
KW - Journal Article
U2 - 10.3109/00365511003786365
DO - 10.3109/00365511003786365
M3 - Journal article
C2 - 20380617
VL - 70
SP - 269
EP - 274
JO - Scandinavian Journal of Clinical and Laboratory Investigation. Supplement
JF - Scandinavian Journal of Clinical and Laboratory Investigation. Supplement
SN - 0085-591X
IS - 4
ER -
ID: 168532445