Clinical and research applications of bone mineral density examinations

Abstract

For over a quarter of a century, various types of examinations measuring bone mineral density (BMD) yielded essential information about bone health and fracture risk and have made a significant impact on osteoporosis research as well as on patient management. Yet care must be exercised when interpreting the results of these, "densitometric," examinations, as pitfalls are common and may be overlooked. Bone densitometric techniques allow quantitative measurement of BMD and are commonly divided into central and peripheral. Central methods allow measurement of BMD in the spine and proximal femur and include dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). Peripheral methods allow measurement of BMD in the phalanges, forearm, tibia, or calcaneus and include peripheral dual X-ray absorptiometry (pDXA) and peripheral quantitative computed tomography (pQCT). Although it does not measure BMD, quantitative ultrasound (QUS) is often included with peripheral methods. This chapter reviews these techniques and puts into perspective the utility of each of these measurements for evaluating bone health and fracture risk.