Advertisement

Performing a DXA PA Lumbar Spine, Proximal Femur, or Forearm DXA Study

  • Sydney Lou Bonnick
  • Lori Ann Lewis
Chapter

Abstract

The most commonly studied regions of the skeleton remain to be the PA lumbar spine, proximal femur, and forearm in spite of the development of software applications that allow measurement of virtually any skeletal region. The manufacturers of DXA devices provide instructions for patient positioning for the different types of DXA studies that can be performed utilizing their device and software applications. While the manufacturer’s recommendations for positioning should always be given priority, an understanding of why certain aspects of positioning are recommended is useful. In particular, the technologist who understands the goals of positioning is better able to modify certain aspects of positioning when the patient’s anatomy demands it, without undermining the validity of the study. In reviewing the basic procedures and nuances of positioning for the three major scan types, the following discussion provides both the basic “how to” as well as the more detailed “why.”

Keywords

Femoral Neck Internal Rotation Proximal Femur Femoral Shaft Ulnar Styloid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Girardi FP, Parvataneni HK, Sandhu HS, et al. Correlation between vertebral body rotation and two-dimensional vertebral bone density measurement. Osteoporos Int. 2001;12:738–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Goh JCH, Low SL, Bose K. Effect of femoral rotation on bone mineral density measurements with dual energy X-ray absorptiometry. Calcif Tissue Int. 1995;57:340–3.PubMedCrossRefGoogle Scholar
  3. 3.
    Cheng XG, Nicholson PHF, Boonen S, et al. Effects of anteversion on femoral bone mineral density and geometry measured by dual energy X-ray absorptiometry: a cadaver study. Bone. 1997;21:113–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Lekamwasam S, Lenora RSJ. Effect of leg rotation on hip bone mineral density measurements. J Clin Densitom. 2003;6:331–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Faulkner KG, Genant HK, McClung M. Bilateral comparison of femoral bone density and hip axis length from single and fan beam DXA scans. Calcif Tissue Int. 1995;56:26–31.PubMedCrossRefGoogle Scholar
  6. 6.
    Bonnick SL, Nichols DL, Sanborn CF, Payne SG, Moen SM, Heiss CJ. Right and left proximal femur analyses: is there a need to do both? Calcif Tissue Int. 1996;58:307–10.PubMedGoogle Scholar
  7. 7.
    Rao AK, Reddy S, Rao DS. Is there a difference between right and left femoral bone density? J Clin Densitom. 2000;3:57–61.PubMedCrossRefGoogle Scholar
  8. 8.
    Petley GW, Taylor PA, Murrills AJ, Dennison E, Pearson G, Cooper C. An investigation of the diagnostic value of bilateral femoral neck bone mineral density measurements. Osteoporos Int. 2000;11:675–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Mazess RB, Nord RH, Hanson JA, Barden HS. Bilateral measurement of femoral bone mineral density. J Clin Densitom. 2000;3:133–40.PubMedCrossRefGoogle Scholar
  10. 10.
    AACE. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract 2010;16(S3):1–37.Google Scholar
  11. 11.
    Hans D, Biot B, Schott AM, Meunier PJ. No diffuse osteoporosis in lumbar scoliosis but lower femoral bone density on the convexity. Bone. 1996;18:15–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Wong JCH, Ong B. Evaluation of femur angle abduction/adduction and bone mineral density values. J Clin Densitom. 2005;8:472–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Shepherd JA, Fan B, Lu Y, et al. Comparison of BMD precision for Prodigy and Delphi spine and femur scans. Osteoporos Int. 2006;17:1303–8.PubMedCrossRefGoogle Scholar
  14. 14.
    White J, Harris SS, Dallal GE, Dawson-Hughes B. Precision of single vs bilateral hip bone mineral density scans. J Clin Densitom. 2003;6:159–62.PubMedCrossRefGoogle Scholar
  15. 15.
    Cole RE. Improving clinical decisions for women at risk of osteoporosis: dual-femur bone mineral density testing. J Am Osteopath Assoc. 2008;108:289–95.PubMedGoogle Scholar
  16. 16.
    Watts NB, Bilezikian JP, Camacho PM, et al. American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract. 2010;16(S3):1016–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Karjalainen P, Alhava EM. Bone mineral content of the forearm in a healthy population. Acta Radiol Oncol Radiat Phys Biol. 1976;16:199–208.CrossRefGoogle Scholar
  18. 18.
    Borg J, Mollgaard A, Riis BJ. Single X-ray absorptiometry: performance characteristics and comparison with single photon absorptiometry. Osteoporos Int. 1995;5:377–81.PubMedCrossRefGoogle Scholar
  19. 19.
    Huddleston AL, Rockwell D, Kulund DN, Harrison B. Bone mass in lifetime tennis athletes. JAMA. 1980;244:1107–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Kannus P, Haapasalo H, Sievanen H, Oja P, Vuori I. The site-specific effects of long-term unilateral activity on bone mineral density and content. Bone. 1994;15:279–84.PubMedCrossRefGoogle Scholar
  21. 21.
    Akesson K, Gardsell P, Sernbo I, Johnell O, Obrant KJ. Earlier wrist fracture: a confounding factor in distal forearm bone screening. Osteoporos Int. 1992;2:201–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Berntsen GKR, Tollan A, Magnus JH, Søgaard AJ, Ringberg T, Fønnebø V. The Tromsø study: artifacts in forearm densitometry-prevalence and effects. Osteoporos Int. 1999;10:425–32.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sydney Lou Bonnick
    • 1
  • Lori Ann Lewis
    • 1
  1. 1.Clinical Research Center of North TexasDentonUSA

Personalised recommendations