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Osteoporosis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Mazen Nasrallah, Marcy B. Bolster
Several noninvasive imaging techniques have been developed to estimate bone mineral density (BMD), which is then used to classify a patient as having osteoporosis (T-score –2.5 or lower), osteopenia (T-score between –1.0 and –2.5), or normal (T-score –1.0 or higher). Imaging techniques include dual-energy X-ray absorptiometry (DXA), single-energy X-ray absorptiometry (SXA), quantitative computed tomography, magnetic resonance imaging (MRI), and broadband ultrasound attenuation.
Machine Learning in Radio Imaging
Published in Punit Gupta, Dinesh Kumar Saini, Rohit Verma, Healthcare Solutions Using Machine Learning and Informatics, 2023
Nitesh Pradhan, Punit Gupta, Anita Shrotriya
Dual-energy X-ray absorptiometry (DXA) images used to diagnose osteoporosis provide a T-score. A T-score value between +1 and −1 indicates healthy bone. A value between −1 and −2.5 shows that the bone has become prone to osteoporosis [2]. This state is called osteopenia. A value below 2.5 is an indication of the poor quality of a bone and a sign of osteoporosis. The decrease in bone mineral density (BMD) characteristic of osteoporosis increases the risk of bone fracture. In Europe, 30% of women over the age of 50 years suffer from osteoporosis [3]. According to a 2000 report, 3.1 to 3.7 million cases of osteoporosis were recorded, with a direct treatment cost of 32 billion dollars, a cost that could rise to 76.8 billion dollars per year in 2050 if this trend continues [4].
Application of dual energy X-ray absorptiometry
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Dual energy X-ray absorptiometry (DXA) is a quantitative imaging procedure for the measurement of bone mineral density (BMD) and the diagnosis of osteopenia and osteoporosis. Given the ability of DXA to concurrently measure whole-body and regional bone, lean and fat mass, DXA has become the method of choice for bone and body composition assessment in athletes. In applied science research and practice, linked to both sporting and clinical groups, DXA is valuable for the evaluation of athlete bone health, recovery from injury and for monitoring the effects of interventions. In a sporting context, DXA is particularly useful for the evaluation of athletes at risk of relative energy deficiency in sports (RED-S), a condition associated with overtraining and/or undernutrition. However, poor-quality DXA acquisition, analysis or reporting may lead to inappropriate scan interpretation, drawing of inaccurate conclusions and uninformed advice to athletes, patients and other colleagues who form part of a multidisciplinary support team. One must also consider the frequency of DXA scanning exposure: although the ionising radiation exposure from DXA is low, scans must always be justified.
Osteopenia/osteoporosis develops in the early phase of disease in patients with idiopathic inflammatory myopathies
Published in Scandinavian Journal of Rheumatology, 2021
B Hanna, E Sakiniene, I Gjertsson, R Pullerits, T Jin
We identified all patients with IIMs in the Rheumatology Department, Sahlgrenska University Hospital, Gothenburg, during 2003–2018. Patients with the following International Classification of Diseases, 10th revision (ICD-10) diagnoses were identified: M331, M33.2, M60.0, M60.8, and M60.9. Out of 133 adult patients, we included only those patients who met the classification criteria for definite/probable polymyositis or dermatomyositis according to Bohan and Peter (3, 4), anti-synthetase syndrome by Connors et al (8), or overlap myositis (9), and for whom the BMD measurements had been performed within 2 years after diagnosis (n = 48). These 48 patients were categorized into three groups: group 1, dual-energy X-ray absorptiometry (DXA) performed during the first month after diagnosis; group 2, DXA performed 2–6 months after diagnosis; and group 3, DXA performed 7–24 months after diagnosis.
Last word: A call to develop specific medical treatment guidelines for adolescent males with eating disorders
Published in Eating Disorders, 2021
Kyle T. Ganson, Stuart B. Murray, Jason M. Nagata
In terms of clinical management, medical treatment guidelines for adolescents with eating disorders that have been outlined by Golden et al. (2015) are not disaggregated by sex and have several components that are specific to females. First, amenorrhea is still used for medical guidance on bone density. It is recommended that dual-energy X-ray absorptiometry (DXA) scans are conducted “when amenorrhea is present for 6 months or more” (Golden et al., 2015, p. 373). This recommendation omits males, despite the fact that adolescent males with eating disorders have been shown to have equally severe deficits in bone mineral density as adolescent females (Nagata et al., 2017). Second, the use of percentage median body mass index (%mBMI) and BMI z-score as a measure of malnutrition could miss boys struggling with an eating disorder, as they are more likely to present at a normal weight or overweight (Vo, Lau, & Rubinstein, 2016). Body mass index is unable to distinguish muscle mass from fat mass; thus, this measure does not have the sensitivity to distinguish males who may have deficits in body fat but are building muscle mass. Adolescents with atypical anorexia nervosa, including males, have been shown to have significant fat mass index deficits despite being at or above a normal weight (Nagata et al., 2019). Third, the weight-loss component included in the medical treatment guidelines may miss adolescent males who are seeking muscularity and a larger body size and may not have overall weight loss (Murray et al., 2017).
Positive IgA against transglutaminase 2 in patients with distal radius and ankle fractures compared to community-based controls
Published in Scandinavian Journal of Gastroenterology, 2018
Anja M. Hjelle, Ellen Apalset, Pawel Mielnik, Roy M. Nilsen, Knut E. A. Lundin, Grethe S. Tell
Low BMD as measured by dual-energy X-ray absorptiometry (DXA) represents a strong risk factor for fractures [23]. The BMD in newly diagnosed adult CD patients improves with a gluten-free diet (GFD), but will in most cases not be restored to normal [24–26]. Asymptomatic CD patients also have lower BMD than expected [27,28] indicating that malabsorption due to villous atrophy is not the main cause. 25OH-vitamin D deficiency which is a risk factor for osteoporosis and falls [29] is common among CD patients (65–70% [30]) and is not related to intestinal injury [31]. CD patients may also have impaired zinc absorption and increased serum pro-inflammatory cytokines [1]. Untreated CD affects osteoclastogenesis and osteoblast activity via the RANKL/RANK/osteoprotegerin pathway, leading to increased bone resorption [32,33].