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==Overview==
==Overview==

Revision as of 22:30, 14 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Eiman Ghaffarpasand, M.D. [2]

Overview

The most important modality for measuring bone mineral density (BMD), that every osteoporosis diagnostic and therapeutic decision are based on, is dual energy X-ray absorptiometry (DEXA). DEXA is a 2-dimensional image of a 3-demensional subject, mainly depends on size of the bone which is studied. Regarding the vast advantages of DEXA, it seems that DEXA will remain the masterpiece of fracture risk assessment and also osteoporosis diagnosis in the future.

Finite element modeling (FEM) is basically an engineering computer-based simulation software. FEM typically simulate the physical loading effects on materials. The effects may be strain or compression, while the subject determined as net-like elements connected to each other.

BMD is focused on density and does not imply for microstructure or architecture of bones. One of the most powerful methods to determine the microstructure is trabecular bone score (TBS) as a complementary method for DEXA.

Osteoporosis other imaging findings

Dual energy X-ray absorptiometery (DEXA, DXA)

Osteopenia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 45995
Osteopenia with forearm measurement - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 45996
Osteoporosis - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 45997

Finite element modelling (FEM)

  • Finite element modeling (FEM) is basically an engineering computer-based simulation software. FEM typically simulate the physical loading effects on materials. The effects may be strain or compression, while the subject determined as net-like elements connected to each other.
  • Currently, basic models for FEM is provided through vQCT scanners, and then elastic properties of bone been measured by use of bone mineral density (BMD) of the position. Finally, all of the anisotropic, inhomogeneous, and complex geometry of the bone are presented.
  • Studies have shown that however osteoporotic vertebrae are capable of bearing daily stresses as same as normal bones, but the stress that is encountered the osteoporotic bone during forward bending may be more severe.[11]

Trabecular bone score (TBS)


References

  1. Messina C, Monaco CG, Ulivieri FM, Sardanelli F, Sconfienza LM (2016). "Dual-energy X-ray absorptiometry body composition in patients with secondary osteoporosis". Eur J Radiol. 85 (8): 1493–8. doi:10.1016/j.ejrad.2016.03.018. PMID 27048946.
  2. Seeman E (1998). "Growth in bone mass and size--are racial and gender differences in bone mineral density more apparent than real?". J. Clin. Endocrinol. Metab. 83 (5): 1414–9. doi:10.1210/jcem.83.5.4844. PMID 9589631.
  3. Black DM, Bouxsein ML, Marshall LM, Cummings SR, Lang TF, Cauley JA, Ensrud KE, Nielson CM, Orwoll ES (2008). "Proximal femoral structure and the prediction of hip fracture in men: a large prospective study using QCT". J. Bone Miner. Res. 23 (8): 1326–33. doi:10.1359/jbmr.080316. PMC 2680175. PMID 18348697.
  4. Cummings SR, Bates D, Black DM (2002). "Clinical use of bone densitometry: scientific review". JAMA. 288 (15): 1889–97. PMID 12377088.
  5. Lorente-Ramos R, Azpeitia-Armán J, Muñoz-Hernández A, García-Gómez JM, Díez-Martínez P, Grande-Bárez M (2011). "Dual-energy x-ray absorptiometry in the diagnosis of osteoporosis: a practical guide". AJR Am J Roentgenol. 196 (4): 897–904. doi:10.2214/AJR.10.5416. PMID 21427343.
  6. Baim S, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Lewiecki EM, Silverman S (2008). "Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Position Development Conference". J Clin Densitom. 11 (1): 75–91. doi:10.1016/j.jocd.2007.12.007. PMID 18442754.
  7. Baim S, Leonard MB, Bianchi ML, Hans DB, Kalkwarf HJ, Langman CB, Rauch F (2008). "Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Pediatric Position Development Conference". J Clin Densitom. 11 (1): 6–21. doi:10.1016/j.jocd.2007.12.002. PMID 18442749.
  8. "WHO IRIS: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis : report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]".
  9. Srinivasan B, Kopperdahl DL, Amin S, Atkinson EJ, Camp J, Robb RA, Riggs BL, Orwoll ES, Melton LJ, Keaveny TM, Khosla S (2012). "Relationship of femoral neck areal bone mineral density to volumetric bone mineral density, bone size, and femoral strength in men and women". Osteoporos Int. 23 (1): 155–62. doi:10.1007/s00198-011-1822-8. PMC 3640410. PMID 22057550.
  10. Jain RK, Vokes T (2017). "Dual-energy X-ray Absorptiometry". J Clin Densitom. doi:10.1016/j.jocd.2017.06.014. PMID 28716497.
  11. Genant HK, Engelke K, Prevrhal S (2008). "Advanced CT bone imaging in osteoporosis". Rheumatology (Oxford). 47 Suppl 4: iv9–16. doi:10.1093/rheumatology/ken180. PMC 2427166. PMID 18556648.
  12. Shevroja E, Lamy O, Kohlmeier L, Koromani F, Rivadeneira F, Hans D (2017). "Use of Trabecular Bone Score (TBS) as a Complementary Approach to Dual-energy X-ray Absorptiometry (DXA) for Fracture Risk Assessment in Clinical Practice". J Clin Densitom. doi:10.1016/j.jocd.2017.06.019. PMID 28734710.
  13. Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP (2014). "Trabecular bone score: a noninvasive analytical method based upon the DXA image". J. Bone Miner. Res. 29 (3): 518–30. doi:10.1002/jbmr.2176. PMID 24443324.

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