PERFORMANCE OF BONE MINERAL DENSITY AT ULTRADISTAL RADIUS IN DIAGNOSIS OF OSTEOPOROSIS AT AXIAL SKELETAL SITES
Keywords:
BMD, Ultradistal radius, Osteoporosis, Diagnostic performanceAbstract
Background: Bone mineral density (BMD) measurement at the forearm has some advantages over at the axial skeletal sites due to lower radiation dose, lower cost, more patient’s comfort, faster scan time and not interfered by abnormal calcification or degenerative change of the spines. Performance of the forearm BMD in the diagnosis of osteoporosis at the axial skeleton in the northeastern Thai women has not been reported.
Objective: The study was aimed to determine the performance of the ultradistal radial BMD in the diagnosis of osteoporosis at the lumbar spines and proximal femur in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio for positive and negative test.
Design: Retrospective, descriptive study
Setting: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
Study methods: Results of 592 BMD measurements simultaneously performed at all three skeletal sites including lumbar spines, proximal femur and ultradistal radius from May 1998 to August 2000 ofall consecutive women were retrospectively reviewed and classified as non-osteoporosis and osteoporosis according to WHO cirteria. The BMD of the lumbar spines and proximal femur was used to be the standard to determine the diagnostic performance of BMD at the ultradistal radius.
Results: High sensitivity of the ultradistal radial BMD for the diagnosis of osteoporosis at the femoral neck and trochanteric regions, 82.9% and 82.5% respectively, was found but the sensitivity for L, , was only 37.5%. Specificity and NPV for the lumbar spines and proximal femoral regions were very high, whereas the likelihood ratio for the positive test for the proximal femoral region was better than that for the lumbar spine region.
Conclusion: The ultradistal radial BMD measurement is a promising method as a screening for the diagnosis of osteoporosis at the proximal femur but it is of limitation when applied for the lumbar spines.
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