BONE DENSITOMETRY
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Transcript of BONE DENSITOMETRY
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BONE DENSITOMETRY
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BONE DENSITOMETRY
• THE ART AND SCIENCE OF MEASURING THE BONE MINERAL CONTENT AND DENSITY OF SPECIFIC SKELETAL SITES OR THE WHOLE BODY.
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THE MOST VERSATILE AND WIDELY USED TECHNIQUE
• DUAL X-RAY ABSORPTIOMETRY
DXA
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DXA
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DXA ADVANTAGES
• LOW RADIATION DOSE
• WIDE AVAILABILITY
• EASE OF USE
• SHORT SCAN TIME
• HIGH RESOLUTION IMAGES
• GOOD PRECISION
• STABLE CALIBRATION
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DXA
• IS A SUBTRACTION TECHNIQUE- SOFT TISSUE STRUCTURES ARE ELIMINATED. X-RAY ATTENUATION OF THE BONE IS MEASURED. BONE MINERAL DENSITY IS CALCULATED
(BMD)
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BMD
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DXA• SCANS PROVIDE IMAGES FOR THE
PURPOSE OF CONFIRMING THE CORRECT POSITIONING OF THE PATIENT AND CORRECT PLACEMENT OF ROI ( REGION OF INTEREST)
• IMAGES ARE NOT USED FOR DIAGNOSIS!!
• THE BONE DENSITY RESULTS ARE COMPUTED AND PRINTED BY SOFTWARE
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DXA COMPUTATIONAL SOFTWARE
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HISTORY• OSTEOPOROSIS UNDETECTED AND OVERLOOKED
UNTIL 1920s.
• THE FIRST PUBLICATION ABOUT BONE MASS APPEARED IN 1930s.
• RA- RADIOGRAPHIC ABSORPTIOMETRY- X-RAY TAKEN AND COMPARED TO A STANDARD
RADIOGRAPH • RADIOGAMMETRY – INTRODUCED IN THE 1960s
IN RESPONSE TO THE MEASUREMENT OF A BONE LOSS IN ASTRONAUTS.
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• IN 1970 CT WAS USED THROUGH THE SPECALIZED SOFTWARE. QUANTITATIVE CT.
• 1970s AND 1980s BROUGHT THE FIRST DEDICATED SCANNERS. FIRST SPA THEN DPA. USED RADIOISOTOPE AS A SOURCE OF RADIATION.
• FIRST COMMERCIAL DXA SCANNER INTRODUCED IN 1987 FIRST USED RADIOISOTOPE AS THE X-RAY SOURCE THEN REPLACED BY THE X-RAY TUBE.
• DXA OF THE HIP AND SPINE IS THE MOST ACCEPTED METHOD FOR MEASURING BONE DENSITY
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CT BONE DENSITOMETRY
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SPA SCANNER
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HIP AND SPINE DXA
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BONE BIOLOGY
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SKELETON PURPOSES
• BODY SUPPORT
• RED BLOOD CELLS MANUFACTURING
• MINERAL STORAGE
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BONE TYPES
• CORTICAL
• TRABECULAR- ( CANCELLOUS)
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BONE CROSS-SECTION
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CORTICAL BONE ACCOUNTS FOR 80% OF SKELETAL MASS
IT SUPPORTS WEIGHT
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TRABECULAR BONE IS THE DELICATE LATTICE WITHIN
THE BONE THAT ADDS STRENGTH
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SPECIFIC BONE
• 40% ORGANIC MATTER
• 60% BONE MINERAL
DXA MEASURES THE DENSITY OF BONE MINERAL
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BONE IS CONSTANTLY GOING HROUGH THE REMODELING
PROCESS
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PEAK BONE MASS AT THE AGE OF 30-35
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DECREASING BONE MASS STARTING AT THE AGE OF
50
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DECREASE IN BONE MASS PRONOUNCED IN WOMEN
AT MENOPAUSE
LOSS OF BONE PRESERVING ESTROGEN!
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OSTEOPOROSIS
Osteoporosis, or "thin" bones, is a disease that gradually weakens bones, making them more fragile and likely to break. It is not a form of arthritis. Osteoporosis leads to an increase in certain types of fractures (broken bones), such as hip fractures, wrist fractures, and compression fractures of the spinal vertebrae (back bones)
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RISK FACTORS FOR OSTEOPOROSIS IN WOMEN
• MENOPAUSE• SMALL BONE FRAME• FAMILY HISTORY• ADVANCED AGE• LOW CALCIUM DIET• INACTIVE LIFESTYLE• CIGARETTE SMOKING• GI MALABSORPTION PROBLEM• CERTAIN MEDICATION USE-
CORTICOSTEROIDS
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MINERAL CONTENT CALCULATION IN BONE
DENSITOMETRY
BMC = BMD X AREA
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DXA SYSTEMS
• PENCIL BEAM
• FAN BEAM
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PENCIL BEAM SCANNER
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FAN BEAM SCANNER