Beyond Dxa: Advances in Clinical Applications of New Bone Imaging Technology |
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| Institution: | 1. From the Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;2. Metabolic Bone Disease Unit, Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York.;1. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States;2. Department of Biomedical Engineering, Indiana University-Purdue University at Indianapolis, IN, United States;3. Department of Anatomy and Cell Biology, Indiana University School of Medicine, IN, United States;4. Roudebush Veterans Administration Medical Center, Indianapolis, IN, United States;5. Department of Orthopaedic Surgery, Indiana University School of Medicine, IN, United States |
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| Abstract: | Dual-energy X-ray absorptiometry (DXA) is generally a very useful tool for assessing bone mineral density (BMD) and fracture risk. However, observational studies have shown that in certain instances, BMD as measured by DXA systematically over- or underestimates fracture risk. We herein describe the clinical conundrums encountered when assessing fracture risk by DXA in patients with primary hyperparathyroidism or type 2 diabetes and those of Chinese ethnicity. Furthermore, we discuss how advanced imaging technology that examines skeletal microarchitecture is furthering our understanding of fracture risk in these clinical situations.Abbreviations:BMD = bone mineral densityBMI = body mass indexBMS = bone material strengthBMT = bone microindentation testing3D = 3-dimensionalDM2 = type 2 diabetes mellitusDXA = dual-energy X-ray absorptiometryμFEA = microstructural finite element analysisFRAX = fracture risk assessment toolHRpQCT = high-resolution peripheral quantitative computed tomographyID = indentation distanceIDI = indentation distance increaseITS = individual trabecular segmentationPHPT = primary hyperparathyroidismPTH = parathyroid hormoneTBS = trabecular bone score |
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