Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift

  • Leon LenchikEmail author
  • Ashley A. Weaver
  • Robert J. Ward
  • John M. Boone
  • Robert D. Boutin
Imaging (D Mintz, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Imaging


Purpose of Review

Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to “opportunistically” screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis.

Recent Findings

Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures.


The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.


Computed tomography Fracture Opportunistic screening Osteoporosis 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Leon Lenchik
    • 1
    Email author
  • Ashley A. Weaver
    • 1
  • Robert J. Ward
    • 2
  • John M. Boone
    • 3
  • Robert D. Boutin
    • 4
  1. 1.Wake Forest School of MedicineMedical Center BoulevardWinston-SalemUSA
  2. 2.Tufts University School of MedicineBostonUSA
  3. 3.University of California Davis Medical CenterSacramentoUSA
  4. 4.University of California Davis School of MedicineSacramentoUSA

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