Corticosteroids

The decrease in BMD at the PA lumbar spine and proximal femur was quantified using DXA (Lunar DPX) in 31 asthmatic subjects (18 men, 13 women) receiving glucocorti-coid therapy and compared with BMD at those sites in age-matched controls (121). The average dose and duration of corticosteroid therapy in these subjects was 16 mg of prednisone equivalents per day for 10 years. BMD of the lumbar spine was 80 of the sex- and age-matched controls. The BMD of the femoral neck, Ward's area, and...

Simple calculated osteoporosis risk estimation

The Simple Calculated Osteoporosis Risk Estimation (SCORE) index was based on an analysis of the relationship between more than 350 variables and osteoporosis (1). The development cohort for SCORE consisted of community-dwelling women, 45 years of age and older, who were recruited from October 1994 to February 1995. There were 1279 postmenopausal women in this cohort. Eighty-nine percent of these women were Caucasian and their average age was 61.5 years. Each woman in this original development...

Additional considerations in site selection for diagnosis

As noted in Chapter 2, the PA lumbar spine is commonly affected by dystrophic calcification in older adults, increasing the measured BMD and T-score. In particular, after the age of 60, the percentage of women having osteophytes in the lumbar spine is estimated at 61 (32). Calcification of the aorta, facet sclerosis, and intervertebral disk calcification can all have a significant effect on bone density measured at the PA lumbar spine (33-38). As a consequence, for diagnosis, the PA lumbar...

Radiotherapy

Bliss et al. (85) reported the development of severe pelvic fractures in 5 patients out of 183 who had been treated with radical radiotherapy for carcinoma of the cervix. Two of these patients with fractures had underlying rheumatoid arthritis. In this report, the authors suggested that underlying connective tissue disorders or low bone mass increased the risk for radionecrosis following irradiation. Tai et al. (86) also reported the incidence of pelvic fractures in 336 women treated for...

References

Embryology, anatomy, and microstructure of bone. In Coe FL, Favus MJ, eds. Disorders of bone and mineral metabolism. New York Raven Press, 1992 219-240. 2. American Medical Association. Current procedural technology 2003. Professional edition. Chicago, IL AMA Press, 2002 287. 3. Dempster DW. Bone remodeling. In Coe FL, Favus MJ, eds. Disorders of bone and mineral metabolism. New York Raven Press, 1992 355-380. 4. Schlenker RA, Von Seggen WW. The distribution of cortical and...

Rheumatoid Arthritis

BMD of the distal and midradius was measured by DXA Norland XR-26 in 34 women with rheumatoid arthritis and compared to 40 controls 92 . The women with rheumatoid arthritis ranged in age from 40 to 79 years with a mean age of 61 years. The average duration of disease was 12 years. BMD in both the distal and midradius was reduced in the women with rheumatoid arthritis who were in their 50s and 60s compared to controls. Women with rheumatoid arthritis in their 40s and 70s did not have BMDs that...

Info

Sydney Lou Bonnick's text Bone Densitometry in Clinical Practice is an expansion of her highly regarded first edition, which has provided the bone densitometry community with simply the best, most accurate, and most precisely written resource in our field. Dr. Bonnick has applied her very careful and exact scientific approaches to expand and improve on her widely regarded initial text. In addition to the chapters in the first edition on the science of bone densitometry...

Effect of Scoliosis Osteoarthritis Osteophytes Surgery and Fracture on BMD in the Proximal Femur

Structural changes and artifacts that interfere with DXA proximal femoral BMD measurements occur less often than at the spine. Osteoarthritic change in the hip joint may cause thickening of the medial cortex and hypertrophy of the trabeculae in the femoral neck, which may increase the BMD in the femoral neck and Ward's area 36 . The trochanteric region is not apparently affected by such change and has been recommended as the preferred site to evaluate in patients with osteoarthritis of the hip...