Bone Densitometry, Radiography, and Quantitative Ultrasound for the Diagnostic Assessment of Osteoporosis
Bone densitometry is an indispensable key technology for the assessment of osteoporosis. In the areas of diagnosis of osteoporosis, quantification of fracture risk assessment, identification of subjects to treat, and monitoring of treatment, bone densitometry can provide valuable information not attainable by other diagnostic approaches.
Both technique-specific and generic strengths and limitations of radiography bone densitometry and ultrasound approaches need to be recognized.
Radiographs cannot be used for identification of early stages of osteoporosis, but they are indispensable for establishing vertebral fracture status.
Among bone densitometry approaches, DXA of the proximal femur is the most valuable and validated diagnostic method, while DXA of the spine has advantages for monitoring treatment.
X-ray- and ultrasound-based techniques have value for assessing fracture risk, but site-matched measurements provide the best results. Rigorous quality-assurance programs need to be implemented, and operators need to be trained thoroughly. The development of better markers for assessing treatment effects is warranted because changes in BMD reflect only part of the fracture risk reduction effect of anti-resorptive therapies.
KeywordsVertebral Fracture Fracture Risk Proximal Femur Quantitative Compute Tomography Bone Densitometry
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