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Semin Musculoskelet Radiol 2024; 28(05): 528-538
DOI: 10.1055/s-0044-1788579
Review Article

DXA: New Concepts and Tools Beyond Bone Mineral Density

Irene Carmen Pizza
1   Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, Milan, Italy
,
Alessia Bongiorno
1   Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, Milan, Italy
,
Martina Pedullà
1   Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, Milan, Italy
,
Domenico Albano
2   IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, Milan, Italy
3   Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
,
Luca Maria Sconfienza
2   IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, Milan, Italy
4   Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
,
Carmelo Messina
2   IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso, Milan, Italy
4   Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
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Abstract

Since its introduction in 1987, dual-energy X-ray absorptiometry (DXA) has revolutionized bone assessment, becoming the gold standard for measuring bone mineral density (BMD). Its low radiation exposure and high accuracy have made it indispensable in diagnosing osteoporosis, aligning with World Health Organization criteria. However, DXA evolution extends beyond BMD measurement, with emerging tools like the Trabecular Bone Score (TBS) and the DXA-based Bone Strain Index (BSI). TBS provides insights into trabecular bone architecture, enhancing the prediction of fracture risk. Despite limitations like body mass index correlation, TBS aids in evaluating patients with conditions such as diabetes and glucocorticoid exposure. BSI, introduced in 2019, evaluates bone strength using finite element analysis, complementing BMD and TBS by assessing bone fatigue.

Advancements in DXA-based tools extend to Hip Structural Analysis and three-dimensional DXA software, offering valuable insights into hip fracture risk. Moreover, DXA serves beyond bone assessment, aiding in abdominal aortic calcification assessment, enhancing cardiovascular risk stratification. In summary, the expanding capabilities of DXA promise comprehensive skeletal and cardiovascular health evaluation, contributing significantly to clinical management and prevention strategies.

Keywords

dual-energy X-ray absorptiometry - bone mineral density - Trabecular Bone Score - Bone Strain Index - 3D-DXA


Publication History

Article published online:
15 October 2024

© 2024. Thieme. All rights reserved.

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