scholarly journals High-Resolution Peripheral Quantitative Computed Tomography (HR-PQCT) and Dual Energy X-Ray Absorptiometry (DXA) Measurements of Proximal Tibia in Patients Undergoing Total Knee Arthroplasty

2016 ◽  
Vol 101 (1-2) ◽  
pp. 64-69
Author(s):  
Mir Sadat-Ali ◽  
Abdallah S. Al-Omran

The aim of the study was to assess bone morphometric indices of the proximal tibia and compare it with bone mineral density (BMD) at hip and lumbar spine and compare with the pQCT. Fifty consecutive patients who underwent total knee arthroplasty (TKA) had a dual energy X-ray absorptiometry (DXA) scan of the upper femur and lumbar spine. Upper tibial cuts were harvested from the tibial condyles and a DXA of tibial cuts was done during TKA. Bone morphometry studies were carried out using HR-pQCT. The bone mineral density at the hip was 0.54 ± 0.08 g/cm2 and spine was 0.73 ± 0.1 with a T score at the hip −2.23 ± 0.44 and spine −2.61 ± 0.45. The bone mineral density of the tibial cut was 0.356 ± 0.03 g/cm2 (P < 0.001) and T score was −6.58 ± 2.87 (P < 0.001). The average bone volume (BV) was 115.27 ± 40.45 mm3, trabecular number (Tb.N) was 1.45 ± 0.32 (1.009–2.37) and trabecular thickness (Tb.Th) was 0.181 ± 0.03 mm (0.111–0.268). The mean bone mineral density measured was 206.24 ± 50.58 mg HA/ccm. This study shows that there is highly significant difference between BMD measured by DXA and pQCT, and that bone morphometric analysis indicates that there is marked decrease in the mechanical properties of the bone in the proximal tibia due to knee Osteoarthritis and Osteoporosis indicating poor bone architecture and quality.

2019 ◽  
Vol 12 ◽  
pp. 117954411984901 ◽  
Author(s):  
Ahad Azami ◽  
Hasan Anari ◽  
Manouchehr Iranparvar ◽  
Amin Azizi ◽  
Afshin Habibzadeh

Objectives: In this study, we aim to evaluate the bone mineral density (BMD) results of 2 standard sites with 3 sites including wrist in diagnosing osteoporosis. Methods: We evaluated the BMD results of 1272 individuals referred for suspected osteoporosis between 2012 and 2015. Those individuals were included with BMD at lumbar spine, femur neck, and wrist. Bone mineral density was measured using a dual-energy X-ray absorptiometry (DXA) device. Bone mineral density and T score were measured for all 3 sites. Results: There was significant correlation between wrist T score with hip T score ( r = 0.606, P < .001) and lumbar T score ( r = 0.527, P < .001). With BMD of 2 sites, patients had osteopenia in 46.3% and osteoporosis in 23.7%, while by adding wrist T-BMD, subjects had osteopenia in 46.6% and osteoporosis in 33%. Between BMD at 2 sites and 3 sites, there was concordance in 81.9%, minor discordance in 17.6%, and major discordance in 0.5%. Conclusions: We observed discordance between BMD measurements of 2 sites and 3 sites, with latter detecting more cases with osteoporosis. In fact, measurement of T scores of wrist along with lumbar and femur neck improves the diagnosis.


2020 ◽  
Vol 9 (12) ◽  
pp. 3961
Author(s):  
Agnieszka Podfigurna ◽  
Marzena Maciejewska-Jeske ◽  
Malgorzata Nadolna ◽  
Paula Mikolajska-Ptas ◽  
Anna Szeliga ◽  
...  

Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. Purpose: The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). Materials and methods: This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-β-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. Results: Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm2) vs. 1.150 ± 0.30 g/cm2) (p = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. −0.144 ± 0.82) (p = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; p < 0.001), T-score (−0.75 ± 1.17 vs. −0.59 ± 1.22; p < 0.001), and Z-score (−0.75 ± 1.12 vs. −0.49 ± 1.11; p < 0.001) after the implementation of HRT when compared to pre-treatment results. Conclusions: In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients.


2021 ◽  
Vol 22 (2) ◽  
pp. 108-113
Author(s):  
Kamun Nahar ◽  
Mohammed Mehedi Al Zahid Bhuiyan ◽  
Muhammad Sirazul Munir ◽  
Habibur Rahman

With an aging population, osteoporosis is increasingly becoming a public health concern. Bangladesh has a high incidence of osteoporosis and occurs among a relatively younger age group than in the developed world. There are several factors that could be associated with bone mineral density (BMD). We are keen to determine the association with BMD and BMI. The study was carried out on 152 patients who were referred to INMAS for dual energy X- ray absorptiometry (DEXA) measurement of bone mineral density (BMD) during the periods of January 2018 to July 2019. BMD was measured at right femoral neck and lumbar spines. Data about age and sex, BMI were recorded. Reporting was done according to the T score following WHO criteria. Prevalence were compared using chi-squared tests. Among 152 patients, 84.9% were females and 15.1% were males. Results showed for right femur that normal bone density in 91 (59.1%), osteopenia in 54 (35.1%), osteoporosis in 9 (5.8%) and BMD in spine was normal in 57 (37.0%) osteopenia in 44 (28.6%), osteoporosis in 53 (34.4%). About 60% of the study population was normal weight and others were underweighted or overweighed. Status of BMD was associated with BMI in the lumbar spine and femur. In this study group, total 61.2% and 26.3%were found low BMD in spine and right femur respectively. In age group ≥ 60 years, low BMD in spinewas 72.0% that is 42.29% higher compare to below 60 years’ group (50.6%).Correlation of BMI with lumbar spine T score, right femur and left femur T score were measured by Pearson’s correlation coefficient test. Positive significant Pearson’s correlation was observedbetween BMI with spine T score (r = 0.397; p = <0.001), BMI with right femur T score (r = 0.347; p = <0.001) and BMI with left femur T score (r = 0.382; p = <0.001). Bangladesh J. Nuclear Med. 22(2): 108-113, Jul 2019


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 227.2-228
Author(s):  
D. Claire ◽  
M. Geoffroy ◽  
L. Kanagaratnam ◽  
C. Isabelle ◽  
A. Hittinger ◽  
...  

Background:Dual energy X-ray absoprtiometry is the reference method to mesure bone mineral density (1). Loss of bone mineral density is significant if it exceeds the least significant change. The threshold value used in general population is 0,03 g/cm2 (2). Patients with obesity are known for having a higher bone mineral density due to metabolism and physiopathology characteristics (3,4).Objectives:The aim of our study was to determine the least significant change in bone densitometry in patients with obesity.Methods:We conducted an interventionnal study in 120 patients with obesity who performed a bone densitometry. We measured twice the bone mineral density at the lumbar spine, the femoral neck and the total hip in the same time (5,6). We determined the least significant change in bone densitometry from each pair of measurements, using the Bland and Altman method. We also determined the least significant change in bone densitometry according to each stage of obesity.Results:The least significant change in bone densitometry in patients with obesity is 0,046g/cm2 at the lumbar spine, 0.069 g/cm2 at the femoral neck and 0.06 g/cm2 at the total hip.Conclusion:The least significant change in bone densitometry in patients with obesity is higher than in general population. These results may improve DXA interpretation in this specific population, and may personnalize their medical care.References:[1]Lees B, Stevenson JC. An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporos Int. mai 1992;2(3):146-52.[2]Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum. oct 2018;85(5):428-40.[3]Shapses SA, Pop LC, Wang Y. Obesity is a concern for bone health with aging. Nutr Res N Y N. mars 2017;39:1-13.[4]Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. juin 2018;17(2):205-17.[5]Roux C, Garnero P, Thomas T, Sabatier J-P, Orcel P, Audran M, et al. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Jt Bone Spine Rev Rhum. janv 2005;72(1):26-31.[6]Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res. août 1999;14(8):1449-56.Disclosure of Interests:None declared.


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