Abstract
Osteoporosis can occur in men and women of any age or ethnicity. Osteoporotic fractures are associated with increased mortality, even in younger patients. Hip fractures and vertebral fractures are public health concerns due to long-term disability and high Cost. The lifetime risk of an osteoporotic fracture in men over the age of 50 years is about 1 in 4, with the chances of a new fracture higher than the lifetime risk of developing prostate cancer. The mortality associated with hip fractures is higher in men that in women. By 2025, the estimated number of hip fractures occurring worldwide in men will be close to that seen in women in 1990. Dualenergy X-ray absorptiometry (DXA) is the gold-standard technology for the diagnosis of osteoporosis and monitoring the skeletal effects of treatment. However, DXA results can sometimes be misleading due to errors in patient positioning, incorrect analysis, invalid data, or poor interpretation. This case presentation illustrates an easily avoidable testing error that could lead to inappropriate treatment decisions, highlighting the importance of quality DXA testing and reporting.
Highlights
Dual-energy X-ray absorptiometry (DXA) is a non-invasive, widely available, modestly priced technology for measuring bone mineral density (BMD)
Despite the ease of performing a DXA study, its clinical utility requires close attention to detail by a well-trained technologist and interpretation by a knowledgeable physician according to well-established standards [6]
The case presented here illustrates the clinical implications of inconsistent selection of a young-adult reference database for calculating T-scores in men
Summary
Dual-energy X-ray absorptiometry (DXA) is a non-invasive, widely available, modestly priced technology for measuring bone mineral density (BMD). It is conveniently performed with a rapid acquisition time and a low dose of ionizing radiation. A 79-year-old Caucasian male presents for a screening DXA scan, as recommend by the US National Osteoporosis Foundation and the International Society for Clinical Densitometry. He is 170 cm (67 inches) tall and weighs 80 kg (176 pounds) with BMI = 26.2. The patient was treated with denosumab, 60 mg subcutaneously, every six months plus calcium and vitamin D
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