Assessing the effect of DXA scanner drift on misclassification of bone density change: The Manitoba BMD registry.

Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is widely used to assess osteoporosis and monitor BMD in untreated and treated individuals. Systematic sources of error can occur with DXA scanners, including calibration drift. Publications suggest a drift tolerance in the range 0.

Diagnosing Osteoporosis for the Spine Practitioner.

Study Design: Literature review.

Objectives: Review updated criteria that categorizes patient's bone health for operative and non-operative patients.

Summary Of Background Data: Osteoporosis is common in spine patients including those with fragility fractures and in the elective surgery population.

The effect of abaloparatide on the proximal femur in men with osteoporosis assessed by three-dimensional dual-energy X-ray absorptiometry.

Abaloparatide treatment significantly increased BMD at the LS, TH, and FN compared with placebo in men with osteoporosis in the phase 3 ATOM trial. The current study used 3D-DXA modeling to evaluate the effects of abaloparatide on cortical and trabecular compartments of the proximal femur in ATOM study participants. Proximal femur DXA images were retrospectively analyzed using 3D-DXA (3D-Shaper software v2.

Optimizing region of interest size and placement for clinical opportunistic CT trabecular bone Hounsfield unit measurements.

Purpose: No formal guidance exists regarding optimal opportunistic computed tomography (CT) region of interest (ROI) size or placement to clinically obtain bone Hounsfield unit (HU) data. Using clinical CT scans, this study evaluated ROI size/placement and assessed HU reproducibility.

Methods: Three non-radiologists independently identified the L1 and L4 vertebral body centroid and then placed varying size circular ROIs on axial and sagittal images of 30 clinical CT scans.

Cross-sectional and longitudinal associations between statin use and bone density: the Manitoba BMD registry.

Statins are among the most widely prescribed medications in older individuals. Inconsistent data in humans suggest that statin medications may be associated with greater BMD and lower risk for osteoporosis. We identified 22 393 individuals aged 40 yr and older undergoing initial (Visit 1) and repeat (Visit 2) TH BMD measurement within 1-10 yr total from DXA through the Manitoba BMD Program (February 28, 1999 to March 29, 2018).

Trabecular bone score predicts distal femur screw pull-out strength better than DXA bone mineral density, CT Hounsfield units, and cortical density.

Unlabelled: The purpose of the study was to evaluate trabecular bone score (TBS) technology for orthopedic application (TBSortho) as a predictor of a screw pull-out strength in a cadaveric model. This study finds that TBSortho correlates more strongly with the screw pull-out strength compared to cortical density, computed tomography (CT) Hounsfield units (HU), and dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD).

Introduction: Patient bone quality impacts the mechanical strength of surgical fixation constructs.

Proton pump inhibitor exposure, trabecular bone score, and BMD: a registry-based cohort study.

Proton pump inhibitors (PPI) are widely prescribed medications. Proton pump inhibitors exposure may be associated with lower trabecular bone score (TBS), but has not shown a consistent effect on BMD. We hypothesized that abdominal obesity, which is associated with both gastroesophageal disease and PPI use, could confound the relationship between PPI use and TBS.

Utility of magnetic resonance imaging-based vertebral bone quality score in recognizing patients at risk for secondary fracture after vertebroplasty.

Objective: The objective of this study was to determine whether the vertebral bone quality (VBQ) score could identify, among patients undergoing vertebroplasty and having probable low bone mineral density, those who were at risk for secondary fracture.

Methods: In this retrospective study, the authors evaluated the medical records of patients with a compression fracture who had undergone vertebroplasty and had preprocedural T1-weighted MRI from January 2016 to January 2021. VBQ scores were calculated as the quotient of the median signal intensity from the L1 to L4 vertebral bodies divided by the signal intensity of L3 cerebrospinal fluid on T1-weighted imaging.

Opportunistic measurement of sagittal abdominal diameter with bone densitometry predicts death and cardiovascular events.

Supine sagittal abdominal diameter (SAD), also known as abdominal height, has been proposed as a simple measure for assessing abdominal adiposity. We aimed to determine whether SAD from DXA performed for osteoporosis assessment predicts major adverse cardiovascular events (MACEs) using the population-based DXA registry for the Province of Manitoba, Canada. The study population comprised 72 974 individuals aged 40 yr and older with baseline DXA assessment between February 1999 and March 2018.

The association of hip bone mineral density (BMD) with incident major osteoporotic and hip fractures varies by body mass index.

Background: Bone mineral density (BMD) measurement is less precise amongst those with body mass index (BMI) > 30 kg/m. We hypothesized that the association of BMD with incident hip and major osteoporotic fractures (MOF; hip, clinical vertebral, forearm, or humerus) becomes weaker with increasing BMI.

Methodology: Our study population was 75,391 individuals age ≥ 50 years who had a bone density test in the province of Manitoba 1998 to 2018.

Bone turnover markers predict changes in bone mineral density in men treated with abaloparatide: results from the abaloparatide for the treatment of men with osteoporosis (ATOM) study.

Early increases in bone turnover markers (BTMs) in response to anabolic therapy correlate with 18-mo BMD increases in postmenopausal women with osteoporosis; however, this relationship has not been assessed in men. In this analysis, the correlation between changes from baseline in fasting intact serum procollagen type I N propeptide (PINP) and serum CTX at 1, 3, 6, and 12 mo and percent increase from baseline in BMD at 12 mo in men from the randomized phase 3 ATOM study (NCT03512262) were evaluated using Pearson's correlation coefficients. The uncoupling index (UI), a measure of the balance between markers of bone formation (PINP) and bone resorption (CTX), with positive UI favoring bone formation, was calculated.

Association of trabecular bone score corrected for tissue thickness with glucose metabolism in acromegaly.

Introduction: Acromegaly is associated with increased vertebral fracture (VF) risk regardless of bone mineral density (BMD). However, the vertebral trabecular compartment is still low; a possible contributor to this may be impaired glucose metabolism (GM) which frequently complicates acromegaly. Additionally, soft tissue thickness may confound bone imaging in acromegaly patients.

Association of standardized serum 25-hydroxyvitamin D with falls in post-menopausal women.

Unlabelled: Vitamin D status has long been related to falls risk. In this planned secondary analysis of a vitamin supplementation trial in postmenopausal women, standardized 25-hydroxyvitamin D concentration up to 60 ng/mL was not associated with increased falls. Women with 25(OH)D ≥ 60 ng/mL had higher odds of ≥ 2 falls.

Treatment reclassification in Canada from the Osteoporosis Canada 2023 clinical practice guidelines: the Manitoba BMD Registry.

Unlabelled: Osteoporosis Canada 2023 clinical practice guidelines increase the number of individuals recommended or suggested for anti-osteoporosis pharmacotherapy by refining treatment guidance for those who fell within the 2010 guidelines' moderate-risk category.

Purpose: In 2023, Osteoporosis Canada updated its 2010 clinical practice guidelines based upon consideration of fracture history, 10-year major osteoporotic fracture (MOF) risk, and BMD T-score in conjunction with age. The 2023 guidelines eliminated risk categories, including the moderate-risk group that did not provide clear treatment guidance.

Intraoperative physician assessment during total hip arthroplasty correlates with DXA parameters.

Purpose: Orthopedic surgeons can assess bone status intraoperatively and recommend skeletal health evaluation for patients with poor bone quality. Intraoperative physician assessment (IPA) at the time of total knee arthroplasty correlates with preoperative DXA-measured bone mineral density (BMD). This study evaluated IPA during total hip arthroplasty (THA) as a quantitative measure of bone status based on tactile assessment.

Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows.

The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated.

Periprosthetic fractures are osteoporotic fractures: missed opportunities for osteoporosis diagnosis.

Unlabelled: Joint replacement surgery is common in older adults, leading to increasing periprosthetic fracture (PPFx) occurrence. We reviewed all PPFx seen over a 4-year period at an academic hospital. Clinical osteoporosis could be diagnosed based on existing data in 104 (67%) at the time of PPFx.

Dual-energy X-ray Absorptiometry Trends Among US Medicare Beneficiaries: 2005-2019.

Introduction: Bone density measured using dual-energy X-ray absorptiometry (DXA) volume, performance site and interpreters have changed in the US since 2005. The purpose of this report is to provide updated trends in DXA counts, rates, place of service and interpreter specialty for the Medicare fee-for-service population.

Methods: The 100 % Medicare Physician/Supplier Procedure Summary Limited Data Set between 2005-2019 was used.