Bone densitometry in clinical practice: application and interpretation
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| Main Author: | |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Totowa, NJ [u.a.]
Humana Press
1998
|
| Series: | Current clinical practice
|
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVIII, 257 S. Ill., graph. Darst. |
| ISBN: | 0896035131 |
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MARC
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| 245 | 1 | 0 | |a Bone densitometry in clinical practice |b application and interpretation |c Sydney Lou Bonnick |
| 264 | 1 | |a Totowa, NJ [u.a.] |b Humana Press |c 1998 | |
| 300 | |a XVIII, 257 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 0 | |a Current clinical practice | |
| 650 | 7 | |a Osteopatias |2 larpcal | |
| 650 | 4 | |a Absorptiometry, Photon |x methods | |
| 650 | 4 | |a Bone Density |x physiology | |
| 650 | 4 | |a Bone and Bones |x radionuclide imaging | |
| 650 | 4 | |a Bone densitometry | |
| 650 | 4 | |a Data Interpretation, Statistical | |
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Record in the Search Index
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| adam_text | CONTENTS
Foreword v
Preface vii
Acknowledgements x
List of Color Plates xii
Chapter 1: Densitometry Techniques in Medicine Today /
Plain Radiography in the Assessment of Bone Density 1
Qualitative Spinal Morphometry and the Singh Index 2
Qualitative Spinal Morphometry 2
The Singh Index 2
Quantitative Morphometric Techniques: Calcar Femorale
Thickness, Radiogrammetry, and the Radiologic
Osteoporosis Score 3
Calcar Femorale Thickness 3
Radiogrammetry 4
The Radiologic Osteoporosis Score 5
Radiographic Photodensitometry 6
Radiographic Absorptiometry (RA) 7
Photon Absorptiometric Techniques 9
Single Photon Absorptiometry (SPA) 9
Dual Photon Absorptiometry (DPA) 11
Dual Energy X Ray Absorptiometry (DXA) 14
Peripheral DXA Units 19
DTX 200 20
pDEXA 21
Peripheral Instantaneous X Ray Imager (PIXI) 21
Single Energy X Ray Absorptiometry (SXA) 22
Quantitative Computed Tomography (QCT) 22
Peripheral QCT 26
References 27
Chapter 2: Densitometric Anatomy 31
The Skeleton in Densitometry 31
Axial and Appendicular Skeleton 31
Weight Bearing and Non Weight Bearing Skeleton 31
Central and Peripheral Skeleton 32
xiii
xiv Contents
Skeletal Site Composition 32
The Spine in Densitometry 34
Vertebral Anatomy 35
Artifacts in AP Spine Densitometry 40
Vertebral Fractures 40
Effect of Osteophytes on BMD 42
Effect of Aortic Calcification on BMD 44
Effect of Facet Sclerosis on BMD 46
Other Causes of Artifacts in AP Spine Studies 46
The Spine in the Lateral Projection 46
The Proximal Femur in Densitometry 50
Proximal Femur Anatomy 50
Effect of Rotation on BMD in the Proximal Femur 53
Effect of Leg Dominance on BMD in the Proximal Femur 55
Effect of Artifacts on BMD in the Proximal Femur 56
The Forearm in Densitometry 57
Nomenclature 57
Effect of Arm Dominance on Forearm BMD 58
Effect of Artifacts on BMD in the Forearm 61
Other Skeletal Sites 61
References 62
Chapter 3: Statistics in Densitometry 65
Mean, Variance, and Standard Deviation 65
The Mean 66
Variance and Standard Deviation 66
Coefficient of Variation 68
Standard Scores 68
Z Scores 68
7 Scores 69
Measures of Risk 71
Prevalence and Incidence 72
Prevalence 72
Incidence 73
Absolute, Relative, and Attributable Risk 73
Absolute Risk 73
Relative Risk 74
Attributable Risk 75
Odds Ratios 75
Confidence Intervals 76
Contents xv
Accuracy and Precision 78
Accuracy 79
Precision 80
Correlation 81
Statistical Significance and the P Value 82
References 82
Chapter 4: The Importance of Precision in Densitometry 83
Performing a Short Term Precision Study 84
Mathematical Procedures Used to Calculate Precision 84
Applying the Precision Value to the Interpretation
of Serial Measurements 87
The Confidence Interval for the Change in BMD
Between Two Measurements 90
Effect of Precision on the Timing of Repeat Measurements
of BMD 93
References 94
Chapter 5: Quality Control Procedures for Densitometry 95
Establishing a Baseline Value with the Phantom 96
Shewhart Rules and CUSUM Charts 98
Shewhart Rules 99
CUSUM Charts 102
Automated Quality Control Procedures 105
References 109
Chapter 6: The Prediction of Fracture Risk
with Densitometry Ill
Prevalence of Fracture at Different Levels of BMD 111
Fracture Risk Prediction 112
Site Specific and Global Fracture Risk Prediction 112
Relative Risk Fracture Data 113
Global Fracture Risk Prediction 114
Site Specific Spine Fracture Risk Prediction 115
Site Specific Hip Fracture Risk Prediction 116
Applying Relative Risk Data in Clinical Practice 117
Lifetime Risk of Fracture 118
Remaining Lifetime Fracture Probability 120
xvi Contents
Fracture Threshold 121
Other Risk Assessments Derived from, or Combined with,
Densitometry 123
Pre Existing Fractures 123
Increasing Number of Low Bone Mass Sites 124
Hip Axis Length 124
References 125
Chapter 7: The Effects of Age, Disease, and Drugs on Bone
Density 127
Age Related Changes in Bone Density 127
Bone Density in Children 128
Bone Density in Premenopausal Women 129
Dissimilar BMDs Between Skeletal Sites at Peak and Prior
to Menopause 129
Bone Density in Perimenopausal Women 130
Dissimilar Spine and Femoral BMD in Perimenopausal Women.. 131
Changes in Bone Density in Postmenopausal Women 132
Changes in Bone Density in Men 133
Diseases Known to Affect Bone Density 134
Acromegaly 134
Alcoholism 134
Amenorrhea 135
Hyperandrogenic Amenorrhea 135
Exercise Induced Amenorrhea 135
Anorexia Nervosa 135
Cirrhosis 136
Diabetes 136
Insulin Dependent Diabetes Mellitus 136
Noninsulin Dependent Diabetes Mellitus (NIDDM) 137
Estrogen Deficiency (Postmenopausal) 137
Gastrectomy 138
Gaucher Disease, Type 1 138
Glutlen Sensitive Enteropathy 138
Human Immunodeficiency Virus Infection 139
Hypercalciuria 139
Hyperparathyroidism 140
Hyperprolactinemia 141
Hyperthyroidism 141
Inflammatory Bowel Disease 142
Intravenous Drug Abuse 143
Contents xvii
Klinefelter s Syndrome 143
Marfan s Syndrome 143
Mastocytosis 144
Multiple Myeloma 144
Multiple Sclerosis 144
Osteoarthritis 145
Paralysis 146
Hemiplegia 146
Paraplegia 147
Parkinson s Disease 147
Pregnancy 147
Renal Failure 148
Rheumatoid Arthritis 148
Thalassemia Major 150
Transient Osteoporosis of the Hip 150
Transplantation 150
Cardiac Transplantation 150
Marrow Transplantation 151
Renal Transplantation 151
Effect of Drugs on Bone Density 152
Alendronate Sodium 152
Calcitriol 152
Calcium and Vitamin D 153
Corticosteroids 154
Oral Corticosteroids 154
Inhaled Corticosteroids 154
Estrogen/Hormone Replacement 155
Etidronate 157
GnRH Agonists 158
Heparin 159
Ipriflavone 159
Medroxyprogesterone Acetate 160
Nandrolone Decanoate 160
Raloxifene 160
Risedronate 161
Salmon Calcitonin 162
Sodium Fluoride 163
Tamoxifen 163
Thyroid Hormone 164
Tibolone 165
References 166
xviii Contents
Chapter 8: Bone Density Data from DP A to DXA
and Manufacturer to Manufacturer 175
From DPA to DXA 176
Hologic DXA and Lunar DPA 176
Lunar DXA and Lunar DPA 177
DXA: From Lunar to Hologic to Norland 178
Hologic DXA and Norland DXA 179
Lunar DXA and Hologic DXA 179
Standardization of Absolute BMD Results 179
From DXA Machine to DXA Machine Within Manufacturers 181
From Pencil Beam to Fan Array DXA Data 182
Reference Databases 184
References 194
Chapter 9: Clinical Indications for Bone Densitometry 197
Clinical Guidelines 197
1988 National Osteoporosis Foundation Guidelines 197
Guidelines of the International Society for Clinical
Densitometry 199
1996 American Association of Clinical Endocrinologists
Guidelines 201
Guidelines from the European Foundation for Osteoporosis
and Bone Disease 202
Guidelines of the Study Group of the World Health Organization
for the Diagnosis of Osteoporosis 203
How Do the Guidelines Compare? 205
Clinical Applications of Bone Mass Measurements 206
Selection of Sites to Measure 206
Assessment of Fracture Risk 207
Quantification of Bone Density 207
Confirmation of Suspected Demineralization
or Skeletal Fragility 207
Diagnosis of Osteoporosis 208
Assessment of the Effect of Disease Processes
on the Skeleton 209
Serial Assessment of Bone Density to Assess the Effects
of Disease or Therapeutic Interventions 210
General Considerations in Site Selection 210
References 211
Chapter 10: Case Studies in Densitometry 213
Index 247
LIST OF COLOR PLATES
Color plates 1—12 appear as an insert following p. 78; color plates 13—
20 appear as an insert following p. 174.
Plate 1 (Fig. 2 1A C from Chapter 2). The lumbar spine viewed from
behind.
Plate 2 (Fig. 2 2 from Chapter 2). A DXA AP spine study acquired on
the Lunar DPX.
Plate 3 (Fig. 2 5 from Chapter 2). A DXA AP spine image acquired on
the Lunar DPX
Plate 4 (Fig. 2 6 from Chapter 2). A DXA AP spine study acquired on
the Norland XR 36.
Plate 5 (Fig. 2 15 from Chapter 2). A DXA AP and lateral lumbar spine
study acquired on the Hologic QDR 4500.
Plate 6 (Fig. 2 19 from Chapter 2). A DXA AP spine study acquired on
the Lunar DPX.
Plate 7 (Fig. 2 20 from Chapter 2). A DXA AP spine study acquired on
the Lunar DPX.
Plate 8 (Fig. 2 21A from Chapter 2). The proximal femur as viewed from
behind.
Plate 9 (Fig. 2 21B from Chapter 2). The proximal femur as seen from
the front.
Plate 10 (Fig. 2 22 from Chapter 2). A DXA proximal femur study
acquired on the Hologic QDR 4500.
Plate 11 (Fig. 2 23 from Chapter 2). Ward s triangle is formed by the
intersection of bundles of trabeculae in the femoral neck.
Plate 12 (Fig. 3 3 from Chapter 3). A DXA AP spine study acquired on
the Norland XR 36.
Plate 13 (Fig. 5 4 from Chapter 5). The Norland XR 36 quality control
screen.
Plate 14 (Fig. 5 5 from Chapter 5). The DTX 200 quality control screen.
Plate 15 (Fig. 10 4 from Chapter 10). Forearm bone density study.
Plate 16 (Fig. 10 6 from Chapter 10). Contour image of the os calcis.
Plate 17 (Fig. 10 5A from Chapter 10). Forearm bone density study.
Plate 18 (Fig. 10 5B from Chapter 10). Forearm bone density ancillary
data.
Plate 19 (Fig. 10 9 from Chapter 10). AP spine bone density data.
Plate 20 (Fig. 10 10 from Chapter 10). Proximal femur bone density
data.
xii
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| institution | BVB |
| isbn | 0896035131 |
| language | English |
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| physical | XVIII, 257 S. Ill., graph. Darst. |
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| publisher | Humana Press |
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| series2 | Current clinical practice |
| spelling | Bonnick, Sydney Lou Verfasser (DE-588)173267947 aut Bone densitometry in clinical practice application and interpretation Sydney Lou Bonnick Totowa, NJ [u.a.] Humana Press 1998 XVIII, 257 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Current clinical practice Osteopatias larpcal Absorptiometry, Photon methods Bone Density physiology Bone and Bones radionuclide imaging Bone densitometry Data Interpretation, Statistical Osteodensitometrie (DE-588)4521032-9 gnd rswk-swf Osteodensitometrie (DE-588)4521032-9 s DE-604 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008572450&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Bonnick, Sydney Lou Bone densitometry in clinical practice application and interpretation Osteopatias larpcal Absorptiometry, Photon methods Bone Density physiology Bone and Bones radionuclide imaging Bone densitometry Data Interpretation, Statistical Osteodensitometrie (DE-588)4521032-9 gnd |
| subject_GND | (DE-588)4521032-9 |
| title | Bone densitometry in clinical practice application and interpretation |
| title_auth | Bone densitometry in clinical practice application and interpretation |
| title_exact_search | Bone densitometry in clinical practice application and interpretation |
| title_full | Bone densitometry in clinical practice application and interpretation Sydney Lou Bonnick |
| title_fullStr | Bone densitometry in clinical practice application and interpretation Sydney Lou Bonnick |
| title_full_unstemmed | Bone densitometry in clinical practice application and interpretation Sydney Lou Bonnick |
| title_short | Bone densitometry in clinical practice |
| title_sort | bone densitometry in clinical practice application and interpretation |
| title_sub | application and interpretation |
| topic | Osteopatias larpcal Absorptiometry, Photon methods Bone Density physiology Bone and Bones radionuclide imaging Bone densitometry Data Interpretation, Statistical Osteodensitometrie (DE-588)4521032-9 gnd |
| topic_facet | Osteopatias Absorptiometry, Photon methods Bone Density physiology Bone and Bones radionuclide imaging Bone densitometry Data Interpretation, Statistical Osteodensitometrie |
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