Dual-energy X-ray absorptiometry applied to the assessment of tibial subchondral bone mineral density in osteoarthritis of the knee
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Plain X-ray is an imprecise tool for monitoring the subchondral bony changes associated with the development of knee osteoarthritis (OA). Our objective was to develop and validate a technique for assessing tibial subchondral bone density (BMD) in knee OA using dual energy X-ray absorptiometry (DXA).
Patients with OA of at least one knee underwent DXA scanning of both knees. Regions of interest (ROI) were placed in the lateral and medial compartments of tibial subchondral bone. Weight-bearing plain X-rays and Te 99m scintiscans of both knees were obtained and scored.
One hundred and twelve patients (223 knees) underwent DXA and radiography. Intra-observer CV% was 2.4% and 1.0% for the medial and lateral ROI respectively. Definite OA (Kellgren and Lawrence Grade 2, 3 or 4) was correlated with age-related preservation of subchondral BMD compared to radiographically normal knees. Raised BMD was also associated with subchondral sclerosis, and positive scintigraphy.
DXA may provide a safe, rapid and reliable means of assessing knee OA. Cross-sectional age-related subchondral tibial BMD loss is attenuated by knee OA.
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Volume 33, Issue 10 , pp 588-595
- Cover Date
- Print ISSN
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- Knee osteoarthritis
- Bone mineral density
- Subchondral bone
- Industry Sectors
- Author Affiliations
- A1. Academic Rheumatology, University Division of Medicine, Bristol Royal Infirmary, Bristol, BS2 8HW, UK
- A2. Department of Radiology, Bristol Royal Infirmary, Bristol, BS2 8HW, UK
- A3. Department of Anatomy, University of Bristol, Bristol, BS2 8EJ, UK
- A4. Department of Pathology and Microbiology, School of Medical Sciences, University of Bristol, Bristol, BS8 1TD, UK