|
Major Discordance in the Diagnosis of Osteoporosis Among Participants With Degenerative Lumbar Spine Using Spine and Hip Dual-Energy X-ray Absorptiometry |
|---|---|
| รหัสดีโอไอ | |
| Creator | Alisara Wongsuttilert |
| Title | Major Discordance in the Diagnosis of Osteoporosis Among Participants With Degenerative Lumbar Spine Using Spine and Hip Dual-Energy X-ray Absorptiometry |
| Contributor | Kasem Chaiklongkit, Sutasinee Kongpromsuk, Wanlop Jaidee |
| Publisher | Faculty of Medicine Ramathibodi Hospital, Mahidol University |
| Publication Year | 2561 |
| Journal Title | Ramathibodi Medical Journal |
| Journal Vol. | 41 |
| Journal No. | 3 |
| Page no. | 013-020 |
| Keyword | Bone mineral density, DXA, Lumbar spine, Degenerative spine disease |
| URL Website | https://www.tci-thaijo.org/index.php/ramajournal |
| Website title | Ramathibodi Medical Journal |
| ISSN | 0125-3611 |
| Abstract | Background: Major T-score discordance in the diagnosis of osteoporosis at spine and the hip may induce misinterpretation in people with degenerative lumbar spine.Objective: To investigate major T-score discordance in the diagnosis of osteoporosis using bone mineral density (BMD) at the lumbar spine and the hip among people with degenerative lumbar spine.Methods: Demographic data, anthropometric measurements, and dual-energy X-ray absorptiometry (DXA) scans at the lumbar spine and the hip were retrieved from a database of Burapha University Hospital. The interrater reliabilities of image interpretation were performed. The correlation between degenerative lumbar spine lesions with T-scores at the lumbar spine and the hip was analyzed. Major discordance was defined when one site is osteoporotic and the other site is osteopenia or normal.Results: Major T-score discordance of the lumbar spine and the hip was 28.6% and the hip BMD detected in participants with osteoporosis was less than the lumbar spine BMD (15.7% vs 36.5%). T-score at lumbar spine showed a false negative rate of 25.0%. Degenerative lumbar spine lesions showed a poor correlation with T-score at the lumbar spine (R2 = 0.21, P < 0.01) and the hip (R2 at femoral neck = 0.24, P < 0.01; R2 at total hip = 0.32, P < 0.01).Conclusions: Twenty-six percent of participants with degenerative lumbar spine were not evaluated L1-L4 BMD. While the hip seems to be the best measurement site, 28.6% of T-score discordance between lumbar spine and hip was still observed. T-score at lumbar spine showed a false negative rate of 25.0% and associated with older age. This study suggested that it would not be suitable to use the hip BMD alone to diagnose osteoporosis in older adults with degenerative spine disease. |
