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

  • Imaging (D Mintz, Section Editor)
  • Published:
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Abstract

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.

Summary

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

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Authors and Affiliations

  1. Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA

    Leon Lenchik & Ashley A. Weaver

  2. Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA

    Robert J. Ward

  3. University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA

    John M. Boone

  4. University of California Davis School of Medicine, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA

    Robert D. Boutin

Authors
  1. Leon Lenchik
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  2. Ashley A. Weaver
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  3. Robert J. Ward
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  4. John M. Boone
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  5. Robert D. Boutin
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Corresponding author

Correspondence to Leon Lenchik.

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

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This article is part of the Topical Collection on Imaging

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Lenchik, L., Weaver, A.A., Ward, R.J. et al. Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift. Curr Rheumatol Rep 20, 74 (2018). https://doi.org/10.1007/s11926-018-0784-7

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  • DOI: https://doi.org/10.1007/s11926-018-0784-7

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