Bone Densitometry, Radiography, and Quantitative Ultrasound for the Diagnostic Assessment of Osteoporosis

  • Claus-C. Glüer


  • 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.


Vertebral Fracture Fracture Risk Proximal Femur Quantitative Compute Tomography Bone Densitometry 
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Further Reading

  1. Meunier PJ (1998) Osteoporosis: Diagnosis and Management. London: Martin Dunitz, p.282.Google Scholar
  2. Genant HK, Guglielmi G, Jergas M (1998) Bone Densitometry and Osteoporosis. Berlin: Springer.Google Scholar
  3. Blake GM, Wahner HW, Fogelman I (1999) The Evaluation of Osteoporosis: Dual X-ray Absorptiometry and Ultrasound in Clinical Practice, 2nd edn. London: Martin Dunitz.Google Scholar
  4. Njeh CF, Hans D, Fuerst T, Glüer CC, Genant HK (1999) Quantitative Ultrasound: Assessment of Osteoporosis and Bone Status. London: Martin Dunitz.Google Scholar

Journal Articles

  1. Kanis J, Glüer CC, for the Committee of Scientific Advisors IOF (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int 11: 192–202.PubMedCrossRefGoogle Scholar
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  3. Grampp S, Genant HK, Mathur A, et al. (1997) Comparisons of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification. J Bone MinerRes 12: 697–711.Google Scholar
  4. Glüer CC and the International Quantitative Ultrasound Consensus Group (1997) Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. J Bone Miner Res 12: 1280–1288.PubMedCrossRefGoogle Scholar
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  6. Link TM, Majumdar S, Grampp S, et al. (1999) Imaging of trabecular bone structure in osteoporosis. Eur Radiol 9: 1781–1788.Google Scholar
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Copyright information

© Springer-Verlag London 2004

Authors and Affiliations

  • Claus-C. Glüer

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