A DXA Primer for the Practicing Clinician A Case-Based Manual for Understanding and Interpreting Bone Densitometry by Angelo A. Licata, Susan E. Williams , Springer

Description

Springer A DXA Primer for the Practicing Clinician A Case-Based Manual for Understanding and Interpreting Bone Densitometry by Angelo A. Licata, Susan E. Williams

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._x000D_ Table of contents :- _x000D_ Introduction_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ What prompted the authors to write this text_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ A brief comment on the Bone & Joint Decade_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ A brief word on the epidemiology of osteoporosis_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Primary disease_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Secondary disease_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ That seen in chronic disease, due to Rx, men, bariatric surgery pts._x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Introduction to Densitometry_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ The gold standard for non-invasive skeletal assessment_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Ultimate goal: prevent fractures_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Limitations: only a 'snap-shot'; can not reveal what has gone on with the bones up to that point_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ The many challenges of DXA_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Obtaining the images_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Interpreting the data_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Even radiologists are prone to errors_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Specific training is essential_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Clinical application to the individual patient_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Looking into the future_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ New technologies_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Vision of an 'optimal' noninvasive, accurate, measure of bone quality_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Chief Medical Officer aboard the USS Enterprise: Lt Commander Leonard "Bones" McCoy_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Hand-held 'tricorder'_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ 3D-QCT_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Finite element analysis (FEA)_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ SECTION I: Fundamental Concepts_x000D_ _x000D_ _x000D_ _x000D_ 1. The History of Non-Invasive Skeletal Assessment_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Imaging Techniques_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Radiographic absorptiometry_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ SPA_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ DPA_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ QCT_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ DXA_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ QUS_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ PIXI_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ 2. Common Terms and Abbreviations Defined _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Accuracy_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Apparent bone mineral density_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ BMD = areal density in g/cm2 in this text _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Areal vs. volumetric_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Bone accretion_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Bone markers_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Bone Mineral Density_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Coefficient of variation_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Database_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Distal 3rd Radius_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ DPA_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ DXA, Central_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ DXA, Peripheral_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Femoral Neck_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Femoral Shaft_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ FRAX - incl application limited to untreated pts. - should not be completed by Techs; emphasize importance of clinical judgment_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Hip, Total_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ LSC_x000D_ _x000D_ _x000D_ _x000D_ _x000D_ _x000D_ Lumbar spine (L1 - L4)_x000D_