Fractures and Repeated Falls
Whereas most fractures are preceded by falls, most falls do not result in fractures (1,2). Clinicians therefore have an ideal opportunity to prevent fractures by identifying those patients who sustain or are likely to sustain repeated falls, a relatively easy task that can be accomplished by merely asking whether the patient fell or had a “near fall” during the past few months. An affirmative answer would trigger either a thorough assessment to identify the etiology of these falls or, given the time limitation, a note to referring physicians alerting them that the patient's fracture risk is increased, independent of ot...
Source: Journal of Clinical Densitometry - July 19, 2017 Category: Radiology Authors: Ronald C. Hamdy Tags: Original Article Source Type: research
Use of Trabecular Bone Score (TBS) as a Complementary Approach to Dual-energy X-ray Absorptiometry (DXA) for Fracture Risk Assessment in Clinical Practice
Osteoporosis is a common bone disease characterized by low bone mass and altered bone microarchitecture, resulting in decreased bone strength with an increased risk of fractures. In clinical practice, physicians can assess the risk of fracture for a patient based on several risk factors. Some such as age, weight, and history of fractures after 50 years of age, parental fracture, smoking status, and alcohol intake are incorporated into FRAX, an assessment tool that estimates the 10-year probability of hip fracture and major osteoporotic fractures based on the individual's risk factors profile. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 19, 2017 Category: Radiology Authors: Enisa Shevroja, Olivier Lamy, Lynn Kohlmeier, Fjorda Koromani, Fernando Rivadeneira, Didier Hans Tags: Original Article Source Type: research
Cross Calibration of the GE Prodigy and iDXA for the Measurement of Total and Regional Body Composition in Adults
Dual-energy X-ray absorptiometry (DXA) body composition measurements are widely performed in both clinical and research settings, and enable the rapid and noninvasive estimation of total and regional fat and lean mass tissues. DXA upgrading can occur during longitudinal monitoring or study; therefore, cross calibration of old and new absorptiometers is required. We compared soft tissue estimations from the GE Prodigy (GE Healthcare, Madison, WI) with the more recent iDXA (GE Healthcare) and developed translational equations to enable Prodigy values to be converted to iDXA values. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 18, 2017 Category: Radiology Authors: Brian Oldroyd, Laura Treadgold, Karen Hind Tags: Original Article Source Type: research
The Clinical Utility of Vertebral Fracture Assessment in Predicting Fractures
Vertebral fracture (VF) is the most common type of osteoporotic fracture. VFs are associated with diminished quality of life and high morbidity and mortality. The presence of a VF, especially a recent one, is an important risk factor for developing another fracture. However, most VFs are not clinically recognized. VF assessment by dual-energy X-ray absorptiometry is a convenient, low-cost, low-radiation, reliable method to identify VFs during bone mineral density measurement. The finding of a previously unrecognized VF may change the diagnostic classification, assessment of fracture risk, and treatment strategies. (Source:...
Source: Journal of Clinical Densitometry - July 18, 2017 Category: Radiology Authors: Joao Lindolfo C. Borges, Isabella Santiago de M Miranda, E. Michael Lewiecki Source Type: research
FRAX Update
The fracture risk assessment tool, FRAX, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, models are now available for 63 countries, covering 79% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 18, 2017 Category: Radiology Authors: John A. Kanis, Nicholas C. Harvey, Helena Johansson, Anders Od én, William D. Leslie, Eugene V. McCloskey Tags: Original Article Source Type: research
Osteoporosis —Assessing Fracture Risk
Fractures are the main presentation, in fact the only presentation and complication, of osteoporosis. Osteoporosis is clinically silent, and the patient remains essentially asymptomatic until a fragility fracture occurs. Although the immediate prognosis after sustaining a fracture is generally good, the long-term impact of these fractures is substantial in terms of disability, morbidity, and even mortality. Consequently, the main goal of treating osteoporosis is fracture risk reduction before a fracture occurs. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 18, 2017 Category: Radiology Authors: Ronald C. Hamdy Source Type: research
Bone Mineralization and Fracture Risk Assessment in the Pediatric Population
Identifying children most susceptible to clinically significant fragility fractures (low trauma fractures or vertebral compression fractures) or recurrent fractures is an important issue facing general pediatricians and subspecialists alike. Over the last decade, several imaging technologies, including dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, have become useful to identify abnormal bone mineralization in children and in adolescents. This review aimed to summarize the latest literature on the utility of these modalities as they pertain to use in pediatrics. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 17, 2017 Category: Radiology Authors: Halley Wasserman, Catherine M. Gordon Source Type: research
Individualized Assessment of Fracture Risk: Contribution of “Osteogenomic Profile”
Over the past decade, several genetic variants or genes for osteoporosis have been identified through genome-wide association studies and candidate gene association studies. These genetic variants are common in the general population but have modest effect sizes, with odds ratio ranging from 1.1 to 1.5. Thus, the utility of any single variant is limited. However, theoretical and empirical studies have suggested that a profiling of multiple variants that are associated with bone phenotypes (i.e., “osteogenomic profile”) can improve the accuracy of fracture prediction and classification beyond that obtained by convention...
Source: Journal of Clinical Densitometry - July 17, 2017 Category: Radiology Authors: Tuan V. Nguyen Tags: Original Article Source Type: research
Fracture Risk Assessment: From Population to Individual
Fracture caused by osteoporosis remains a major public health burden on contemporary populations because fracture is associated with a substantial increase in the risk of mortality. Early identification of high-risk individuals for prevention is a priority in osteoporosis research. Over the past decade, few risk prediction models, including the Garvan Fracture Risk Calculator (Garvan) and FRAX ®, have been developed to provide absolute (individualized) risk of fracture. Recent validation studies suggested that the area under the receiver operating characteristic curve in fracture discrimination ranged from 0.61 to 0.83 fo...
Source: Journal of Clinical Densitometry - July 17, 2017 Category: Radiology Authors: Tuan V. Nguyen, John A. Eisman Tags: Original Article Source Type: research
Fracture Risk Assessment in Patients With Diabetes Mellitus
Diabetes mellitus, both type 1 and type 2 (T2DM), is associated with decreased bone strength as well as increased fracture risk. Bone mineral density is decreased in type 1 diabetes but increased in T2DM, compared with controls. This suggests alterations in bone quality are a major player in the pathogenesis of fragility fractures in patients with diabetes. The link between diabetes and bone appears to be mediated by complex pathways, including the insulin-insulin growth factors system, accumulation of advanced glycation end-products in bone collagen, microangiopathy, and increased bone marrow fat content. (Source: Journal...
Source: Journal of Clinical Densitometry - July 14, 2017 Category: Radiology Authors: Catalina Poiana, Cristina Capatina Source Type: research
Overview of Fracture Prediction Tools
The characterization of risk factors for fracture that contribute significantly to fracture risk, over and above that provided by the bone mineral density, has stimulated the development of risk assessment tools. The more adequately evaluated tools, all available online, include the FRAX ® tool, the Garvan fracture risk calculator and, in the United Kingdom only, QFracture®. Differences in the input variables, output, and model construct give rise to marked differences in the computed risks from each calculator. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 14, 2017 Category: Radiology Authors: John A. Kanis, Nicholas C. Harvey, Helena Johansson, Anders Od én, Eugene V. McCloskey, William D. Leslie Tags: Original Article Source Type: research
Dual-energy X-ray Absorptiometry
Bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) is the most commonly used method to assess fracture risk. DXA utilizes two different energy X-rays to calculate BMD and, by comparison to a young normative database, the T-score. In 1994, the World Health Organization defined osteoporosis based on T-score, changing the paradigm of the field and forever placing DXA measurements in the center of osteoporosis diagnosis. Since then, many large studies have demonstrated the predictive value of BMD by DXA —for every standard deviation decline in BMD, there is a relative risk of 1.5–2.5 for fract...
Source: Journal of Clinical Densitometry - July 14, 2017 Category: Radiology Authors: Rajesh K. Jain, Tamara Vokes Source Type: research
Bone Turnover Markers: Use in Fracture Prediction
Bone turnover markers (BTMs) provide us with a noninvasive approach to studying bone turnover and they can be measured easily and with good precision, especially using automated analyzers. BTMs increase at menopause, and these higher levels are associated with more rapid bone loss. In some but not all studies, they are also associated with greater risk of fracture. However, the evidence base for use as predictors of fracture is not robust, and so BTMs have not been included in fracture prediction models. (Source: Journal of Clinical Densitometry)
Source: Journal of Clinical Densitometry - July 14, 2017 Category: Radiology Authors: Tatiane Vilaca, Fatma Gossiel, Richard Eastell Tags: Original Article Source Type: research
Judo Practice in Early Age Promotes High Level of Bone Mass Acquisition of Growing Boys' Skeleton
The current study aimed to exhibit effects of judo training for at least 2 yr on bone mass parameters in growing boys. Our population was composed of one hundred and thirty boys in tanner stage 1 and aged 10.52 ± 0.86 yr. Eleven judo players were therefore, excluded from the study because they do not have participate regularly to the judo training sessions during the last 2 yr. The resting sample was divided into two groups: 50 judo players (JU group) and 69 controls (C group). Bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were evaluated by using dual-photon X-ray absorptiometry on weight-bear...
Source: Journal of Clinical Densitometry - July 13, 2017 Category: Radiology Authors: Kawther Missawi, Mohamed Zouch, Hamada Chaari, Yosra Chakroun, Zouhair Tabka, Ely ès Bouajina Tags: Original Article Source Type: research
