By Angelo A. Licata
Despite public conception, osteoporosis continues to be a common, devastating illness, and a truly critical and expensive public well-being probability. Early detection and remedy needs to be a concern for basic future health care services. Dual-energy X-ray absorptiometry (DXA) is the central x-ray expertise used to diagnose osteoporosis in its early, asymptomatic levels, to evaluate therapy efficacy, and to steer remedy judgements. It continues to be the surest today. A DXA Primer for the training Clinician: A Case-Based handbook for knowing and examining Bone Densitometry is constructed round actual situations of sufferers’ DXA measurements. The content material is derived from displays given by means of the authors at a countrywide society education direction and exemplifies not just the full physique of schooling supplied via those lectures however the complete diversity of formerly undiscussed nuances besides. This sensible, easy-to-read identify presents the everyday difficulties of DXA utilization that new clients may well come upon and that education classes wouldn't have time to supply intimately. The significant concentration of the booklet is the presentation of what's basic and what's problematical within the use of DXA, depicting numerous situations with actual case histories of sufferers, their corresponding DXA photos and the information that designate the issues. detailed in strategy and presentation, this case-based handbook can be of colossal worth to all practitioners -- and scholars – attracted to supplying optimum prognosis and therapy of osteoporosis.
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Extra info for A DXA Primer for the Practicing Clinician: A Case-Based Manual for Understanding and Interpreting Bone Densitometry
7 % and other fracture risk 18 %. Although the clinician felt the data were not severe enough to warrant more than the usual non-pharmacological approach, the FRAX® analysis exceeded the intervention threshold for her 10-year risk of hip fracture and should give the clinician reason to reconsider the treatment plan. Case 3 An active, normal-weight 81-year-old widow underwent initial BMD due to the patient noticing some height loss. The interpretive report is noted in Fig. 2a. The report indicated “osteopenia,” and the primary care physician chose not to prescribe any medical interventions.
A. E. 1007/978-1-4419-1375-3_4, © Springer Science+Business Media New York 2014 35 36 4 What Is FRAX®? The dilemma which this poses for the practitioner is that patients who are younger, of either gender, or are pre- or perimenopausal that have T-scores that could indicate osteoporosis and risk for fragility fracture but by virtue of their clinical characteristics indeed may not have this problem. 4 in the spine. Does this patient need pharmaceutical therapy? What is her fracture risk? This conundrum is addressed by FRAX®, a fracture risk assessment tool developed by the World Health Organization.
The technologist then ensures that the leg and hip are positioned such that the hip is rotated into the anatomically neutral position while maintaining proper alignment on the table (Fig. 11). Fig. 11 Arrival at the Imaging Center and DXA Suite 27 The DXA arm moves down and up the table once again to capture the image while the technologist checks the hip image for quality and proper patient positioning (Fig. 12). It is important to note here that if the hip is positioned properly, very little if any of the lesser trochanter should be visible.
A DXA Primer for the Practicing Clinician: A Case-Based Manual for Understanding and Interpreting Bone Densitometry by Angelo A. Licata