Digital X-ray radiogrammetry better identifies osteoarthritis patients with a low bone mineral density than quantitative ultrasound

Eur Radiol. 2007 Apr;17(4):965-74. doi: 10.1007/s00330-006-0382-3. Epub 2006 Sep 5.


This study assessed the ability of quantitative ultrasound (QUS) and digital X-ray radiogrammetry (DXR) to identify osteopenia and osteoporosis in patients with knee osteoarthritis (OA). One hundred and sixty-one patients with painful knee OA (81 men, 80 women; age 62.6+/-9.2 years, range 40-82 years) were included in this cross-sectional study and underwent dual-energy X-ray absorptiometry (DXA) of both hips and the lumbar spine, QUS of the phalanges and calcanei of both hands and heels, and DXR using radiographs of both hands. Unpaired t-test, Mann-Whitney U test, ROC analysis and Spearman's rank correlation were used for comparisons and correlation of methods. Using DXA as the reference standard, we defined a low bone mineral density (BMD) as a T-score < or =-1.0 at the lumbar spine or proximal femur. In contrast to phalangeal or calcaneal QUS, DXR was able to discriminate patients with a low BMD at the lumbar spine (p<0.0001) or hips (p<0.0001). ROC analysis showed that DXR had an acceptable predictive power in identifying OA patients a low hip BMD (sensitivity 70%, specificity 71%). Therefore, DXR used as a screening tool could help in identifying patients with knee OA for DXA.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon / methods*
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Density*
  • Calcaneus / diagnostic imaging
  • Cross-Sectional Studies
  • Female
  • Hip / diagnostic imaging
  • Humans
  • Knee* / diagnostic imaging
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Metacarpal Bones / diagnostic imaging
  • Middle Aged
  • Osteoarthritis / diagnosis*
  • Osteoarthritis / diagnostic imaging*
  • Ultrasonography / methods*