An investigation of the diagnostic value of bilateral femoral neck bone mineral density measurements
An investigation of the diagnostic value of bilateral femoral neck bone mineral density measurements
This paper describes a study to assess the clinical value of bilateral femoral neck bone mineral density (BMD) measurements. Although a range of factors will determine clinical decisions, the classification of the site with the lowest T-score is likely to have significant bearing on the management of a patient. While it is common practice to measure BMD at the lumbar spine and a single neck of femur, knowledge of the BMD of the second femur may also be of diagnostic value. Using dual-energy X-ray absorptiometry, BMD of the lumbar spine and right and left femoral neck was measured in a group of 2372 white, Caucasian women (mean age +/- SD, 56.6 +/- 13.9 years) routinely referred for bone densitometry. Analysis of the measurements showed a significant (p = 0.02) but small difference between the mean BMD of the right (0.840 +/- 0.152 g/cm2) and left (0.837 +/- 0.150 g/cm2) femoral neck. Further investigation of femur scans revealed 79 (3.3%) patients in whom one side was osteoporotic while the other side and spine were normal or osteopenic using the World Health Organization diagnostic criteria in combination with manufacturer's reference data. Patients in whom the femoral neck BMD measurements differed by less than the precision error of the system were then excluded. This left only 51 (2.2%) patients, that is 29 (1.2%) for right femur and spine scan and 22 (0.9%) for left femur and spine scan, in whom knowledge of both femoral neck BMD measurements could have altered the classification of the lowest site assessed to osteoporotic. These data suggest that there is only a small benefit from performing bilateral femoral neck BMD measurements. Since BMD measurements are only one of a range of factors considered as part of a patient's management, it is suggested that the extra time, cost and radiation dose associated with measurement of the second femur may not be justified.
675-679
Petley, G.W.
4f2da40b-3c7b-4adc-b75c-e24e62bb1cf0
Taylor, P.A.
9315d36c-6664-4d46-a422-f3d16ef4e7d5
Murrills, A.J.
4874f921-548f-4ac4-9195-34326e37e6cd
Dennison, E.
ee647287-edb4-4392-8361-e59fd505b1d1
Pearson, G.
2206c4ec-f443-4db5-a83d-2ed2bb696034
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
2000
Petley, G.W.
4f2da40b-3c7b-4adc-b75c-e24e62bb1cf0
Taylor, P.A.
9315d36c-6664-4d46-a422-f3d16ef4e7d5
Murrills, A.J.
4874f921-548f-4ac4-9195-34326e37e6cd
Dennison, E.
ee647287-edb4-4392-8361-e59fd505b1d1
Pearson, G.
2206c4ec-f443-4db5-a83d-2ed2bb696034
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Petley, G.W., Taylor, P.A., Murrills, A.J., Dennison, E., Pearson, G. and Cooper, C.
(2000)
An investigation of the diagnostic value of bilateral femoral neck bone mineral density measurements.
Osteoporosis International, 11 (8), .
(PMID:11095170)
Abstract
This paper describes a study to assess the clinical value of bilateral femoral neck bone mineral density (BMD) measurements. Although a range of factors will determine clinical decisions, the classification of the site with the lowest T-score is likely to have significant bearing on the management of a patient. While it is common practice to measure BMD at the lumbar spine and a single neck of femur, knowledge of the BMD of the second femur may also be of diagnostic value. Using dual-energy X-ray absorptiometry, BMD of the lumbar spine and right and left femoral neck was measured in a group of 2372 white, Caucasian women (mean age +/- SD, 56.6 +/- 13.9 years) routinely referred for bone densitometry. Analysis of the measurements showed a significant (p = 0.02) but small difference between the mean BMD of the right (0.840 +/- 0.152 g/cm2) and left (0.837 +/- 0.150 g/cm2) femoral neck. Further investigation of femur scans revealed 79 (3.3%) patients in whom one side was osteoporotic while the other side and spine were normal or osteopenic using the World Health Organization diagnostic criteria in combination with manufacturer's reference data. Patients in whom the femoral neck BMD measurements differed by less than the precision error of the system were then excluded. This left only 51 (2.2%) patients, that is 29 (1.2%) for right femur and spine scan and 22 (0.9%) for left femur and spine scan, in whom knowledge of both femoral neck BMD measurements could have altered the classification of the lowest site assessed to osteoporotic. These data suggest that there is only a small benefit from performing bilateral femoral neck BMD measurements. Since BMD measurements are only one of a range of factors considered as part of a patient's management, it is suggested that the extra time, cost and radiation dose associated with measurement of the second femur may not be justified.
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Published date: 2000
Organisations:
Clinical & Experimental Sciences
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Local EPrints ID: 383385
URI: http://eprints.soton.ac.uk/id/eprint/383385
ISSN: 0937-941X
PURE UUID: 1802ebb9-9803-4542-a9d8-dea83643a916
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Date deposited: 29 Jan 2016 11:18
Last modified: 18 Mar 2024 02:45
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P.A. Taylor
Author:
A.J. Murrills
Author:
G. Pearson
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