The Fallacy of BMD: A Critical Review of the Diagnostic Use of Dual X-ray Absorptiometry
- S. Pors Nielsen
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The diagnostic use of BMD should be cautious as BMD is not an ideal measure of true bone density; it is not an ideal measure of bone strength; it does not predict fractures well; and it has inherent problems of accuracy and linearity. The limitations of BMD, based on the physical deficiencies of DXA, are further obscured by the introduction of T-scores.
It is suggested that BMD and BMC, when used diagnostically and for fracture risk classification, be used after correction for body size and/or bone size, age and sex, and that measured values be evaluated in the light of established mean fracture incidence data. BMD is not a parameter of sufficient validity to be the sole indicator of present and future fracture risk. A low BMD should be regarded one of several fracture risk factors.
It seems that there is a need to redefine the T-score based definition of osteoporosis.
- The Fallacy of BMD: A Critical Review of the Diagnostic Use of Dual X-ray Absorptiometry
Volume 19, Issue 3 , pp 174-183
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- Springer-Verlag London Limited
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- Key words:Bone mineral density – Dual X-ray absorptiometry – Fracture risk – Osteoporosis
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- S. Pors Nielsen (A1)
- Author Affiliations
- A1. Department of Clinical Physiology and Nuclear Medicine, Hillerød Hospital, Hillerød, Denmark, DK