Bone Densitometry

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Forearm

Structure that is only scanned with bone densitometry when the spine or hip scans are not obtainable

Loose clothing or gown with no dense objects (zippers or belts)

things that a patient should wear and be instructed to wear for bone densitometry

Osteoclasts

Bone cells that breakdown and reabsorb old bone

Osteoblasts

Bone cells that build new bone and repair bone

Proximal femur

Bone that is best to determine risk factors for hip fractures

3d analysis and true volumetric measurement

Can only be provided by QCT

Lateral

Patient position for assessment of the thoracolumbar spine for vertebral fracture analysis

MSP with midline of table, legs positioned for true AP of the hip, and feet rotated inward

Patient position for bone densitometry of the hip

Supine with MSp to midline of table

Patient position for bone densitometry of the spine

Premenopausal women and men younger than 50

People for whom the Z score is primarily used

30 - 50 %

Percent loss of trabecular bone that will produce the first visible changes on radiographs

Vertebral heights

Are measured and compared with a reference value in vertebral fracture assessment

Risk for fragility fracture

Increases when a patient has a low BMD

High and low x-ray energy

Is commonly used in the technique on a DEXA machine to determine the mass of tissues

Good measurement precision

Is essential for detecting changes in bone mass density

Bone mineral report

Is taken when the site of interest is analyzed with DXA

Vertebral fracture assessment

A new method of bone densitometry that uses software to diagnose current and potential vertebral fractures

BMC (bone mineral content)

A quantity of minerals in the entire bone measured in grams

BMD (bone mineral density)

A ratio of BMC in a specific area of bone

Thoracic hump

A sign of advanced stage osteoporosis

Bone densitometry

A specialty diagnostic modality used to evaluate bone mineral density for diagnosis of osteoporosis

Quantitative computed tomography (QCT)

Alternative modality for bone densitometry that can measure both trabecular and cortical bone and allows three dimensional or volumetric analysis of data

Quantitative ultrasound (QUS)

Alternative modality for bone densitometry that uses nonionizing techniques to evaluate peripheral sites in people that are excessively overweight

BMD and clinical risk factors

Are the most accurate to predict future fractures

Energy switching system or rare earth filters

Are used to achieve the high and low x-ray energies used to determine the mass of tissues

Accuracy

How well the measured value reflects the true or actual value of the object

Osteocytes

Mature bone cells

Peripheral site selection

May be performed with single energy x-ray absorptiometry, central densitometry, or QUS

ALARA principles

Must always be practiced by the technologist when performing bone densitometry

Benefits

Must always outweigh the risks in bone densitometry

Precision (reproducibility)

The ability of a quantitative measurement technique to reproduce the same numerical result when repeatedly performed in an identical fashion

2.7 for each of 1 standard deviation in BMD

The amount that age adjusted relative risk for fracture increases as BMD decreases

30 microSV

The approximate dose range for QCT

QC procedures not updated to ensure accurate results, bone mass to low/ body part to thick, anatomic malformations, previous fracture or metallic prosthesis, new procedures, and pregnancy

The contraindications for bone densitometry

Less than 5 microSv

The effective dose from a bone density exam of both spine and hip

Every 18 months

The frequency of re-examination in most protocols to evaluate change

Gender age, family history, ethnicity, body habitus, lifestyle, estrogen deficiency, nutritional deficiency, frequent falls, alcohol / tobacco abuse, hyperparathyroidism, steroid use for rheumatoid arthritis, GI conditions, and medications

The indications for a bone densitometry procedure

Short term and long term variability of scanner, patient motion, body habitus, and technical factors

The influencing factors that affect precision of DXA

Dual energy x-ray absorptiometry (DEXA or DXA)

The machine used for bone densitometry

Central/ axial

The most common site for bone densitometry

Heel (os calcis)

The most common site for quantitative ultrasound

Greater than or equal to -1.0

The normal T score

Greater than or equal to -2.0

The normal Z score within expected range

T score

The number of SDs the individual's BMD is from the mean BMD of a young normal population of the same sex and ethnic background

Z score

The number of SDs the individual's BMD is from the mean BMD of age appropriate individuals

Measure bone mineral density, detect bone loss, establish diagnosis of osteoporosis, asses risk of fracture, assess response of patient to osteoporosis therapy, and vertebral fracture assessment

The purposes of bone densitometry

T12 - L4

The region of the spine that must be included on bone densitometry of the spine

Inhibitors of bone resorption or stimulants of bone formation

The two types of osteoporosis management drugs

+/- 10%

The typical accuracy of a DXA unit that is sufficient for clinical assessment of fracture risk and diagnosis of osteoporosis

Bone density

Thing that is best evaluated with bone densitometry equipment

Body habitus and soft tissue variations

Things of which a technologist must be aware for each patient to ensure that an appropriate amount of soft tissue is available for adequate scan analysis

Patient's history and associated risk factors

Things on which site selection for bone densitometry is determined

True and measure values expressed and percentage values

Values that are compared to determine the accuracy of a DEXA unit

Bone break

Was the first indicator of osteoporosis before bone densitometry

Various locations of the body or through whole body scan acquisition

Ways in which bone mineral analysis can be performed

Standard radiographs of the dorsal and lumber spine

Were used to determine bone density before bone densitometry. osteoporosis is not visible one these images until later portions of the disease


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