Radiology of Osteoporosis

Part of the series Medical Radiology pp 105-124

Dual-Energy X-Ray Absorptiometry

  • Judith E. AdamsAffiliated withDepartment of Clinical Radiology, Imaging Science and Biomedical Engineering, Stopford Medical School, University of Manchester

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Osteoporosis is the most common metabolic bone disease. It is characterised by reduced bone mass, altered bone architecture and the clinical consequence of fracture with little or no trauma (low-trauma fractures, insufficiency fractures). These fractures tend to occur most commonly in sites of the skeleton that are rich in trabecular bone: the wrist, spine and hip. It is the last of these which has the greatest morbidity and mortality, but all osteoporotic fractures result in pain and suffering for patients and have considerable socio-economic impact on health care systems and society generally (Cooper 1996). 1 in 2 women and 1 in 5 men over the age of 50 years will suffer a fracture in their lifetime in the Western world (van Staa et al. 2001). In the past 20 years there have been significant advances in knowledge of the epidemiology, patho-physiology, and treatment of osteoporosis (Sambrook and Cooper 2006). These therapies increase bone mineral density (BMD) by between 5–12% and, more importantly, reduce future fracture risk to a greater magnitude (decrements between 30–70%) (Royal College of Physicians 1999, 2000; Meunier 2001; Compston 2005; Poole and Compston 2006; Keen 2007).