Leon Lenchik1, Ashley A Weaver2, Robert J Ward3, John M Boone4, Robert D Boutin5. 1. Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. llenchik@wakehealth.edu. 2. Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. 3. Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA. 4. University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA. 5. University of California Davis School of Medicine, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
Abstract
PURPOSE OF REVIEW: Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to "opportunistically" screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis. RECENT FINDINGS: Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures. The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.
PURPOSE OF REVIEW: Osteoporosis is disproportionately common in rheumatologypatients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to "opportunistically" screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis. RECENT FINDINGS: Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures. The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.
Authors: Timothy J Ziemlewicz; Alyssa Maciejewski; Neil Binkley; Alan D Brett; J Keenan Brown; Perry J Pickhardt Journal: J Bone Miner Res Date: 2016-05-06 Impact factor: 6.741
Authors: Elizabeth B Gausden; Benedict U Nwachukwu; Joseph J Schreiber; Dean G Lorich; Joseph M Lane Journal: J Bone Joint Surg Am Date: 2017-09-20 Impact factor: 5.284
Authors: Kristen M Beavers; Michael P Walkup; Ashley A Weaver; Leon Lenchik; Stephen B Kritchevsky; Barbara J Nicklas; Walter T Ambrosius; Joel D Stitzel; Thomas C Register; Sue A Shapses; Anthony P Marsh; W Jack Rejeski Journal: J Bone Miner Res Date: 2018-08-07 Impact factor: 6.741
Authors: Celia L Gregson; David J Armstrong; Jean Bowden; Cyrus Cooper; John Edwards; Neil J L Gittoes; Nicholas Harvey; John Kanis; Sarah Leyland; Rebecca Low; Eugene McCloskey; Katie Moss; Jane Parker; Zoe Paskins; Kenneth Poole; David M Reid; Mike Stone; Julia Thomson; Nic Vine; Juliet Compston Journal: Arch Osteoporos Date: 2022-04-05 Impact factor: 2.879
Authors: M S LeBoff; S L Greenspan; K L Insogna; E M Lewiecki; K G Saag; A J Singer; E S Siris Journal: Osteoporos Int Date: 2022-04-28 Impact factor: 5.071
Authors: Max J Scheyerer; Bernhard Ullrich; Georg Osterhoff; Ulrich A Spiegl; Klaus J Schnake Journal: Unfallchirurg Date: 2019-08 Impact factor: 1.000
Authors: Andrew M McDonald; Eddy S Yang; Kenneth G Saag; Emily B Levitan; Nicole C Wright; John B Fiveash; Soroush Rais-Bahrami; Smita Bhatia Journal: Arch Osteoporos Date: 2020-02-29 Impact factor: 2.617
Authors: David Zopfs; Simon Lennartz; Charlotte Zaeske; Martin Merkt; Kai Roman Laukamp; Robert Peter Reimer; David Maintz; Jan Borggrefe; Nils Grosse Hokamp Journal: Br J Radiol Date: 2020-03-04 Impact factor: 3.039
Authors: Nithin Manohar Rayudu; Michael Dieckmeyer; Maximilian T Löffler; Peter B Noël; Jan S Kirschke; Thomas Baum; Karupppasamy Subburaj Journal: Front Endocrinol (Lausanne) Date: 2021-01-19 Impact factor: 5.555
Authors: Justin J Tse; Ainsley C J Smith; Michael T Kuczynski; Daphne A Kaketsis; Sarah L Manske Journal: Curr Osteoporos Rep Date: 2021-07-22 Impact factor: 5.096
Authors: Nithin Manohar Rayudu; Karupppasamy Subburaj; Kai Mei; Michael Dieckmeyer; Jan S Kirschke; Peter B Noël; Thomas Baum Journal: Front Endocrinol (Lausanne) Date: 2020-07-28 Impact factor: 5.555
Authors: Veena Aggarwal; Christina Maslen; Richard L Abel; Pinaki Bhattacharya; Paul A Bromiley; Emma M Clark; Juliet E Compston; Nicola Crabtree; Jennifer S Gregory; Eleni P Kariki; Nicholas C Harvey; Kate A Ward; Kenneth E S Poole Journal: Ther Adv Musculoskelet Dis Date: 2021-07-10 Impact factor: 5.346