BJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ryan, P J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ryan, P J
British Journal of Radiology 74 (2001),1137-1141 © 2001 The British Institute of Radiology

Full paper

Bone densitometry in the management of Colles' fractures: which site to measure?

P J Ryan, MD, FRCP

Osteoporosis Unit, Department of Nuclear Medicine, Medway Maritime Hospital, Windmill Road, Gillingham, Kent ME7 5NY, UK

This study assessed whether patients with Colles' fractures can be evaluated by measurement of peripheral bone mineral density (BMD) instead of the more established axial BMD technique. 205 consecutive patients who had sustained a recent Colles' fracture were invited to attend for BMD measurement at the lumbar spine, hip and forearm by dual energy X-ray absorptiometry (DXA) using a Hologic QDR4500C instrument. Hologic normal reference ranges were used for spine and ultradistal radius BMD, and the NHANES 111 reference range was used for the femoral neck. 158 patients attended, of whom only 61 had a T-score below -2.5 at one of the three measured sites (84 T<-2.0, 112 T<-1.5). 36 patients had bilateral forearm fractures and did not undergo a forearm measurement. After excluding these patients and using a T-score of -2.5 as a diagnostic threshold, a spine and hip measurement strategy missed 26% of osteoporotic patients and a forearm only strategy missed 33%. If a forearm strategy is adopted, with axial BMD performed only on those patients with an ultradistal radial T-score of <-1.5 and >-2.5, 27 further scans would be required and only four patients with T<-2.5 at the spine or hip would be undetected. Where axial BMD measurement is performed, this should be accompanied by forearm BMD measurement in some patients with Colles' fractures. A peripheral bone mineral densitometry strategy using forearm BMD alone will miss many individuals with osteoporosis. Therefore where forearm, and probably any peripheral scanning method, only is used for patient assessment there should be close liaison with an axial BMD centre with agreed joint protocols, as some patients should be advised to have an additional axial BMD measurement following their peripheral BMD measurement.




This article has been cited by other articles:


Home page
Arch Intern MedHome page
M. L. Gourlay and S. A. Brown
Clinical Considerations in Premenopausal Osteoporosis
Arch Intern Med, March 22, 2004; 164(6): 603 - 614.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
BJR DMFR IMAGING  ALL BIR JOURNALS 
Copyright © 2001 by the British Institute of Radiology.