FP7 Is peripheral dexa useful for osteoporosis screening? (Family Practice).

FP7 IS PERIPHERAL DEXA USEFUL FOR OSTEOPOROSIS SCREENING? Amolak Singh, MD, FACP, FACNM. University of Missouri Hospital & Clinics Columbia, Mo.

Appendicular determination of bone mineral density (BMD) using Dual Energy X-ray Absorptiometry (DEXA) provides accurate, convenient, yet inexpensive measurements of appendicular BMD. Appendicular osteopenia may be present in variety of conditions including primary or involutional osteoporosis and secondary osteoporosis. The Peripheral DEXA (PD) is most useful for assessing appendicular fracture risk (eg, Colle's fracture) and may be just as good as Central (hip and spine) DEXA in conditions such as hyperparathyroidism. However, in osteoporosis when the trabecular bone is preferentially lost, Central DEXA is more appropriate. The PD is relatively inexpensive and may be useful in osteoporosis screening in a population that cannot afford to have Central DEXA. Four hundred and forty eight patients underwent PD. There were 402 females and 46 males. We performed 212 calcaneous and 236 forearm (distal radius and ulna) PD studies. The studies were done with a low cost PD unit called PIXI (Lunar Corp.). The technique is simple, fast, and has a high precision. The in-vitro and in-vivo precision is 0.5% and 1.5% respectively. Significant osteopenia was defined as a T-Score > -1.2. The severity of the osteopenia was graded as mild if T-Score was > -1.2 but < -2.0, moderate if T-Score was > -2.0 but <-3.0 and severe if T-Score was > -3.0. Significant osteopenia was found in 173 of 448 (39%) of patients with age ranging 21-97 years (mean age, 63 [+ or -] 13). Of those with osteopenia, the severity was mild in 91 (53%), moderate in 61(35%), and severe in 21(12%) of patients. The calcaneous and forearm measurements were equally effective in screening. The osteoporosis was more common in females (39%) than males (33%). The older patients exhibited more severe osteopenia. The PD is useful for osteoporosis screening, when Central DEXA is cost-prohibitive or unavailable. Moreover, the technique is suitable for off site applications and can be performed at places convenient to many patients. For under-privileged population of the wo rld, the PD may be most affordable procedure for osteoporosis screening.