Ali Yavuz Karahan1, Bugra Kaya2, Banu Kuran3, Ozlem Altındag4, Pelin Yildirim5, Sevil Ceyhan Dogan6, Aynur Basaran7, Ender Salbas8, Turgay Altınbilek9, Tuba Guler5, Sena Tolu10, Zekiye Hasbek11, Banu Ordahan7, Ercan Kaydok12, Ufuk Yucel12, Selcuk Yesilyurt13, Almula Demir Polat14, Murat Cubukcu15, Omer Nas16, Umit Sarp16, Ozan Yasar17, Seher Kucuksarac7, Gozde Turkoglu7, Ahmet Karadag18, Sinan Bagcaci19, Kemal Erol20, Emel Guler21, Serpil Tuna22, Ahmet Yildirim23, Savas Karpuz7. 1. Department of Physical Medicine and Rehabilitation, Beyhekim State Hospital of Konya, Konya, Turkey. ayk222@hotmail.com. 2. Department of Nuclear Medicine of Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey. 3. Department of Physical Medicine and Rehabilitation, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. 4. Department of Physical Medicine and Rehabilitation, Gaziantep University Sahinbey Research and Training Hospital, Gaziantep, Turkey. 5. Department of Physical Medicine and Rehabilitation, Derince Training and Research Hospital, Kocaeli, Turkey. 6. Department of Physical Medicine and Rehabilitation, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey. 7. Department of Physical Medicine and Rehabilitation, Beyhekim State Hospital of Konya, Konya, Turkey. 8. Department of Physical Medicine and Rehabilitation, State Hospital of Agri, Agri, Turkey. 9. Department of Physical Medicine and Rehabilitation, Physical therapy High school of Health Sciences of University of Halic, Istanbul, Turkey. 10. Department of Physical Medicine and Rehabilitation, Medipol University, Faculty of Medicine, Istanbul, Turkey. 11. Department of Nuclear Medicine, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey. 12. Department of Physical Medicine and Rehabilitation, State Hospital of Nevsehir, Nevsehir, Turkey. 13. Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Hospital of Yoncali, Kutahya, Turkey. 14. Department of Physical Medicine and Rehabilitation, State Hospital of Afyon, Afyon, Turkey. 15. Department of Physical Medicine and Rehabilitation, State Hospital of Denizli, Denizli, Turkey. 16. Department of Physical Medicine and Rehabilitation, State Hospital of Yozgat, Yozgat, Turkey. 17. Department of Physical Medicine and Rehabilitation, Amasya University Sabuncuoglu Serefeddin Research and Training Hospital, Amasya, Turkey. 18. Department of Physical Medicine and Rehabilitation, State Hospital of Sivas, Sivas, Turkey. 19. Department of Physical Medicine and Rehabilitation, State Hospital of Hakkari, Hakkari, Turkey. 20. Department of Physical Medicine and Rehabilitation, State Hospital of Nigde, Nigde, Turkey. 21. Department of Physical Medicine and Rehabilitation, Kayseri Training and Research Hospital, Kayseri, Turkey. 22. Department of Physical Medicine and Rehabilitation, Akdeniz University, Faculty of Medicine, Antalya, Turkey. 23. Department of Orthopedics and Traumatology, Beyhekim State Hospital of Konya, Konya, Turkey.
Abstract
BACKGROUND: Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. METHODS: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. RESULTS: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. CONCLUSION: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation.
BACKGROUND:Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. METHODS: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. RESULTS: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. CONCLUSION: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation.
Entities:
Keywords:
Diagnosis; Dual Energy X-ray Absorptiometry; Education; Osteoporosis; Technician