A Dxa Primer for the Practicing Clinician Paperback Book

A Dxa Primer for the Practicing Clinician: A Case-Based Manual for Understanding and Interpreting Bone DensitometryAuthor: Susan E. Williams Angelo A. Licata
Publisher: Springer
Category: Medical Diagnosis, Musculoskeletal Medicine, Endocrinology, Rheumatology
Book Format: Paperback

Despite public perception, osteoporosis remains a widespread, devastating disease, and a very serious and costly public health threat. Early detection and treatment must be a priority for primary health care providers. Dual-energy X-ray absorptiometry (DXA) is the principal x-ray technology used to diagnose osteoporosis in its early, asymptomatic stages, to assess treatment efficacy, and to guide treatment decisions. It remains the gold standard today. A DXA Primer for the Practicing Clinician: A Case-Based Manual for Understanding and Interpreting Bone Densitometry is developed around real cases of patients' DXA measurements. The content is derived from presentations given by the authors at a national society training course and exemplifies not only the complete body of education provided through these lectures but the full range of previously undiscussed nuances as well. This practical, easy-to-read title provides the day to day problems of DXA usage that new users may encounter and that training courses do not have time to provide in detail. The central focus of the book is the presentation of what is normal and what is problematic in the use of DXA, depicting various scenarios with real case histories of patients, their corresponding DXA images and the data that explain the problems. Unique in approach and presentation, this case-based manual will be of immense value to all practitioners -- and students - interested in providing optimal diagnosis and treatment of osteoporosis.

Table Of ContentsIntroduction





What prompted the authors to write this text


A brief comment on the Bone & Joint Decade


A brief word on the epidemiology of osteoporosis



Primary disease


Secondary disease



That seen in chronic disease, due to Rx, men, bariatric surgery pts.




Introduction to Densitometry



The gold standard for non-invasive skeletal assessment


Ultimate goal: prevent fractures


Limitations: only a 'snap-shot'; can not reveal what has gone on with the bones up to that point



The many challenges of DXA



Obtaining the images


Interpreting the data



Even radiologists are prone to errors


Specific training is essential



Clinical application to the individual patient



Looking into the future



New technologies



Vision of an 'optimal' noninvasive, accurate, measure of bone quality


Chief Medical Officer aboard the USS Enterprise: Lt Commander Leonard "Bones" McCoy



Hand-held 'tricorder'




3D-QCT



Finite element analysis (FEA)







SECTION I: Fundamental Concepts

1. The History of Non-Invasive Skeletal Assessment





Imaging Techniques



Radiographic absorptiometry


SPA


DPA


QCT


DXA


QUS



PIXI







2. Common Terms and Abbreviations Defined





Accuracy


Apparent bone mineral density


BMD = areal density in g/cm2 in this text



Areal vs. volumetric



Bone accretion


Bone markers


Bone Mineral Density


Coefficient of variation


Database


Distal 3rd Radius


DPA


DXA, Central


DXA, Peripheral


Femoral Neck


Femoral Shaft


FRAX - incl application limited to untreated pts. - should not be completed by Techs; emphasize importance of clinical judgment


Hip, Total


LSC


Lumbar spine (L1 - L4)