Identification of Men With Reduced Bone Density at the Lumbar Spine and Femoral Neck Using BMD of the Os Calcis

doi:10.1385/JCD:7:2:134

Journal of Clinical Densitometry

Volume 7, Issue 2, Summer 2004, Pages 134-142

https://doi.org/10.1385/JCD:7:2:134 Get rights and content

Abstract

We assessed the utility of os calcis (OC) bone mineral density (BMD) measurements to identify men with low BMD at the lumbar spine (LS) and femoral neck (FN). BMD was measured by dual X-ray absorptiometry (DXA). Receiver operator characteristics (ROC) analysis was applied to determine the risk of osteoporosis at the lumbar spine or femoral neck. [A total of 230 men with an average age of 59 yr were studied.] The most common reasons for referral were fracture (47%) and steroid use (46%). Twenty-six percent were osteoporotic at the LS, 21% at the FN, and 15% at the OC. Optimal classification with respect to osteoporotic measurements at the LS or FN was obtained at an OC T-score of –1.9 (BMD = 0.45 g/cm²). Osteoporosis was only weakly related to a simple cumulative risk factor score, but was strongly related to a T-score OC categorized into quartiles. Regression analysis of BMD on the major risk factors alone explained only 17% of the variance in BMD at the LS and 5% at the FN. The combination of the T-score at the OC, age, and weight provided the best model. BMD OC is superior to risk factors alone in the clinical evaluation and selection of men referred for axial densitometry.

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Cross-Calibration and Minimum Precision Standards for Dual-Energy X-ray Absorptiometry: The 2005 ISCD Official Positions
2006, Journal of Clinical Densitometry
Citation Excerpt :
If this minimum standard could not be achieved, then the technologist would need to be retrained. Fifty-eight recent precision studies (13–70) from selected journals were identified and reviewed by the committee. Some of the studies were represented twice, and every effort was made to try to represent a single dataset once in the analysis.
The International Society for Clinical Densitometry (ISCD) Committee on Standards of Bone Measurement (CSBM) consists of experts in technical aspects of bone densitometry. The CSBM recently reviewed the scientific literature on cross-calibration and precision assessment. A report with recommendations was presented at the 2005 ISCD Position Development Conference (PDC). Based on a thorough review of the data by the ISCD Expert Panel during the conference, the ISCD adopted Official Positions with respect to (1) cross-calibration when changing or replacing hardware; (2) the approach to cross-calibration when an entire system is changed to one made by either the same or a different manufacturer; (3) when no cross-calibration study or bone mineral density (BMD) comparison is done between facilities; and (4) the minimum acceptable precision for an individual technologist. We present here the ISCD Official Positions on these topics that were established as a result of the 2005 PDC, together with the associated rationales and supportive evidence.
Prevalence of osteoporosis using DXA bone mineral density measurements at the calcaneus: Cut-off points of diagnosis and exclusion of osteoporosis
2005, Journal of Clinical Densitometry
The objective of this article is to evaluate different T-score cut-off points in the calcaneus in order to establish the prevalence of osteoporosis in the general population and to evaluate the clinical value of bone mineral density at the calcaneus as a tool to identify patients with spine or hip osteoporosis.
A total of 1455 people (727 women and 728 men) from the Hortega cohort were studied. The densitometric studies were carried out in the calcaneal region using a Peripheral Instantaneous X-ray Imaging (PIXI) Lunar bone densitometer. We established three cut-off points (−1.6, −2.0, −2.5). One-hundred twenty-five patients (67 men with a mean age of 47 ±13 yr and 58 women with a mean age of 66 ±8 yr) from internal medicine outpatient clinics who were undergoing densitometry of the calcaneus, spine, and hip were subsequently studied. The prevalence of osteoporosis in women with a calcaneus T-score −1.6 was 12.4%, which is comparable to the 12.7% obtained with an axial densitometer in a Spanish population. The prevalence in men was 7.8%, with a calcaneus T-score of <−2.0. In women, the highest sensitivity (85%) was obtained with a calcaneus T-score of <−1.0 and the highest specificity with a calcaneus T-score of <−2.5. In men, the best sensitivity (61%) was obtained with a calcaneus T-score of <−1.0 and the best specificity (98%) with a calcaneus T-score of <−2.5. A calcaneus T-score <−1.6 is an adequate cut-off to establish the prevalence of osteoporosis in population studies. In women, a calcaneus T-score of >−1.0 enables the diagnosis of the disease to be excluded, whereas a calcaneus T-score of <−2.5 enables the diagnosis to be confirmed and treatment to be initiated in both men and women.
Bone density at the os calcis: Reference values, reproducibility, and effects of fracture history and physical activity
2005, Archives of Disease in Childhood

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Original ArticleIdentification of Men With Reduced Bone Density at the Lumbar Spine and Femoral Neck Using BMD of the Os Calcis

Abstract

Bone Miner

How many women have osteoporosis?

J Bone Miner Res

Cyclical etidronate in the management of osteoporosis in men

Rev Contemp Pharmacother

Management of male osteoporosis, report of the UK Consensus Group

Q J Med

Hip fracture in elderly men and women: validation in the Rotterdam Study

J Bone Miner Res

Bone density and fracture risk in men

J Bone Miner Res

Risk factors for hip fracture in white men: the NHANES Epidemiologic Follow-up Study

J Bone Miner Res

Prediction of osteoporotic fractures by postural instability and bone density

Br Med J

Assessing bone density in men

J Bone Miner Res

From density to structure: growing up and growing old on the surfaces of bone

J Bone Miner Res

Osteoporosis in men

Osteoporos Int

Original Article
Identification of Men With Reduced Bone Density at the Lumbar Spine and Femoral Neck Using BMD of the Os Calcis