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BONE MINERAL DENSITY (BMD) bmd (Technique (Spine ROI (Cover from L1-L4,…
BONE MINERAL DENSITY (BMD)
Easy reliable test to measure density or thickness of bones
Measure amount of mineral (calcium) in a specific area of the bone
Technique
Spine ROI
Cover from L1-L4
Lines are parallel to intervertebral space
Delete osteophyte
Hip Joint Position
Patient's foot is placed in a brace
Rotates hip inward
Lumbar Spine Position
Support patient's leg with a padded box
Flatten pelvis and lumbar spine
Hip ROI
Femur image shows
Femoral neck
Ischium
Greater trochanter
X-ray tube below the patient while detector is above the patient
Alternative: Forearm
Indications
Hyperparathyroidism
Hip/spine cannot be interpreted
Obese patients
ROI
Reference line at distal tip of ulna styloid process
Vertical line between radius and ulna
Patient lies on a padded table
Osteoporosis diagnosis
Cortical thinning
Increased radiolucency
Procedure
Soft tissue amount subtracted from total
Remaining = patient's bone mineral density
Special software compute and display bone density measurements on the computer
DEXA machine transmits low dose x-ray beam
x-ray with 2 distinct energy peaks
absorbed by soft tissue
absorbed by bone
Indications
Hyperparathyroidism
Glucocorticoid therapy
Vertebral abnormlities
Women at risk for osteoporosis
Lack adequate estrogen replacement therapy (ERT)
Family history
History of anorexia
Contraindications
Previous fracture/placement of metallic prosthesis
Pregnancy
Anatomic malformations at ROI
Severe scoliosis
Kyphosis
ROI is too thick
Internal Artifacts
Previous contrast media introduced
Bony lesions
Osteoarthritis
Scoring
T-score
Compares BMD with a healthy young adult
Z-score
Compares BMD with people of same age, gender and ethnicity
