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Dual-energy X-ray absorptiometry applied to the assessment of tibial subchondral bone mineral density in osteoarthritis of the knee

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Abstract

Objective

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).

Design

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.

Results

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.

Conclusion

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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Acknowledgements

This work was in part funded by a programme grant from the Arthritis Research Campaign. We also wish to thank Ms. Vicki Parkin and the Radiology team at the Bristol Royal Infirmary for their help and support

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Authors and Affiliations

  1. Academic Rheumatology, University Division of Medicine, Bristol Royal Infirmary, Bristol, BS2 8HW, UK

    S. Clarke, J. Duddy, G. Nickols & J. R. Kirwan

  2. Department of Radiology, Bristol Royal Infirmary, Bristol, BS2 8HW, UK

    C. Wakeley, I. Watt & K. Ellingham

  3. Department of Anatomy, University of Bristol, Bristol, BS2 8EJ, UK

    M. Sharif

  4. Department of Pathology and Microbiology, School of Medical Sciences, University of Bristol, Bristol, BS8 1TD, UK

    C. J. Elson

Authors
  1. S. Clarke
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  2. C. Wakeley
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  3. J. Duddy
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  4. M. Sharif
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  5. I. Watt
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  6. K. Ellingham
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  7. C. J. Elson
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  8. G. Nickols
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  9. J. R. Kirwan
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Corresponding author

Correspondence to S. Clarke.

Additional information

Work completed at Bristol Royal Infirmary, Bristol, BS2 8HW, UK

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Clarke, S., Wakeley, C., Duddy, J. et al. Dual-energy X-ray absorptiometry applied to the assessment of tibial subchondral bone mineral density in osteoarthritis of the knee. Skeletal Radiol 33, 588–595 (2004). https://doi.org/10.1007/s00256-004-0790-x

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  • DOI: https://doi.org/10.1007/s00256-004-0790-x

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