bone densitometry. the art and science of measuring the bone mineral content and density of specific...
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BONE DENSITOMETRY
BONE DENSITOMETRY
• THE ART AND SCIENCE OF MEASURING THE BONE MINERAL CONTENT AND DENSITY OF SPECIFIC SKELETAL SITES OR THE WHOLE BODY.
THE MOST VERSATILE AND WIDELY USED TECHNIQUE
• DUAL X-RAY ABSORPTIOMETRY
DXA
DXA
DXA ADVANTAGES
• LOW RADIATION DOSE
• WIDE AVAILABILITY
• EASE OF USE
• SHORT SCAN TIME
• HIGH RESOLUTION IMAGES
• GOOD PRECISION
• STABLE CALIBRATION
DXA
• IS A SUBTRACTION TECHNIQUE- SOFT TISSUE STRUCTURES ARE ELIMINATED. X-RAY ATTENUATION OF THE BONE IS MEASURED. BONE MINERAL DENSITY IS CALCULATED
(BMD)
BMD
DXA• SCANS PROVIDE IMAGES FOR THE
PURPOSE OF CONFIRMING THE CORRECT POSITIONING OF THE PATIENT AND CORRECT PLACEMENT OF ROI ( REGION OF INTEREST)
• IMAGES ARE NOT USED FOR DIAGNOSIS!!
• THE BONE DENSITY RESULTS ARE COMPUTED AND PRINTED BY SOFTWARE
DXA COMPUTATIONAL SOFTWARE
HISTORY• OSTEOPOROSIS UNDETECTED AND OVERLOOKED
UNTIL 1920s.
• THE FIRST PUBLICATION ABOUT BONE MASS APPEARED IN 1930s.
• RA- RADIOGRAPHIC ABSORPTIOMETRY- X-RAY TAKEN AND COMPARED TO A STANDARD
RADIOGRAPH • RADIOGAMMETRY – INTRODUCED IN THE 1960s
IN RESPONSE TO THE MEASUREMENT OF A BONE LOSS IN ASTRONAUTS.
• IN 1970 CT WAS USED THROUGH THE SPECALIZED SOFTWARE. QUANTITATIVE CT.
• 1970s AND 1980s BROUGHT THE FIRST DEDICATED SCANNERS. FIRST SPA THEN DPA. USED RADIOISOTOPE AS A SOURCE OF RADIATION.
• FIRST COMMERCIAL DXA SCANNER INTRODUCED IN 1987 FIRST USED RADIOISOTOPE AS THE X-RAY SOURCE THEN REPLACED BY THE X-RAY TUBE.
• DXA OF THE HIP AND SPINE IS THE MOST ACCEPTED METHOD FOR MEASURING BONE DENSITY
CT BONE DENSITOMETRY
SPA SCANNER
HIP AND SPINE DXA
BONE BIOLOGY
SKELETON PURPOSES
• BODY SUPPORT
• RED BLOOD CELLS MANUFACTURING
• MINERAL STORAGE
BONE TYPES
• CORTICAL
• TRABECULAR- ( CANCELLOUS)
BONE CROSS-SECTION
CORTICAL BONE ACCOUNTS FOR 80% OF SKELETAL MASS
IT SUPPORTS WEIGHT
TRABECULAR BONE IS THE DELICATE LATTICE WITHIN
THE BONE THAT ADDS STRENGTH
SPECIFIC BONE
• 40% ORGANIC MATTER
• 60% BONE MINERAL
DXA MEASURES THE DENSITY OF BONE MINERAL
BONE IS CONSTANTLY GOING HROUGH THE REMODELING
PROCESS
PEAK BONE MASS AT THE AGE OF 30-35
DECREASING BONE MASS STARTING AT THE AGE OF
50
DECREASE IN BONE MASS PRONOUNCED IN WOMEN
AT MENOPAUSE
LOSS OF BONE PRESERVING ESTROGEN!
OSTEOPOROSIS
Osteoporosis, or "thin" bones, is a disease that gradually weakens bones, making them more fragile and likely to break. It is not a form of arthritis. Osteoporosis leads to an increase in certain types of fractures (broken bones), such as hip fractures, wrist fractures, and compression fractures of the spinal vertebrae (back bones)
RISK FACTORS FOR OSTEOPOROSIS IN WOMEN
• MENOPAUSE• SMALL BONE FRAME• FAMILY HISTORY• ADVANCED AGE• LOW CALCIUM DIET• INACTIVE LIFESTYLE• CIGARETTE SMOKING• GI MALABSORPTION PROBLEM• CERTAIN MEDICATION USE-
CORTICOSTEROIDS
MINERAL CONTENT CALCULATION IN BONE
DENSITOMETRY
BMC = BMD X AREA
DXA SYSTEMS
• PENCIL BEAM
• FAN BEAM
PENCIL BEAM SCANNER
FAN BEAM SCANNER