A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology

S Bobo Tanner, Charles F Moore JrDivision of Rheumatology, Vanderbilt University Medical Center, Nashville, TN, USAAbstract: The principal use of dual-energy X-ray absorptiometry (DXA) is to diagnose and monitor osteoporosis and therefore reduce fracture risk, associated morbidity, and mortality. In...

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Autores principales:	Tanner SB, Moore Jr CF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/c7c096984eaa4947a063ac4dbeed2bb0
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spelling	oai:doaj.org-article:c7c096984eaa4947a063ac4dbeed2bb02021-12-02T06:15:48ZA review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology1179-156Xhttps://doaj.org/article/c7c096984eaa4947a063ac4dbeed2bb02012-12-01T00:00:00Zhttp://www.dovepress.com/a-review-of-the-use-of-dual-energy-x-ray-absorptiometry-dxa-in-rheumat-a11732https://doaj.org/toc/1179-156XS Bobo Tanner, Charles F Moore JrDivision of Rheumatology, Vanderbilt University Medical Center, Nashville, TN, USAAbstract: The principal use of dual-energy X-ray absorptiometry (DXA) is to diagnose and monitor osteoporosis and therefore reduce fracture risk, associated morbidity, and mortality. In the field of rheumatology, DXA is an essential component of patient care because of both rheumatologists&rsquo; prescription of glucocorticoid treatment as well as the effects of rheumatological diseases on bone health. This review will summarize the use of DXA in the field of rheumatology, including the concern for glucocorticoid-induced osteoporosis, as well as the association of osteoporosis with a sampling of such rheumatologic conditions as rheumatoid arthritis (RA), systemic lupus erythematosus, ankylosing spondylitis, juvenile idiopathic arthritis, and scleroderma or systemic sclerosis. Medicare guidelines recognize the need to perform DXA studies in patients treated with glucocorticoids, and the World Health Organization FRAX tool uses data from DXA as well as the independent risk factors of RA and glucocorticoid use to predict fracture risk. However, patient access to DXA measurement in the US is in jeopardy as a result of reimbursement restrictions. DXA technology can simultaneously be used to discover vertebral fractures with vertebral fracture assessment and provide patients with a rapid, convenient, and low-radiation opportunity to clarify future fracture and comorbidity risks. An emerging use of DXA technology is the analysis of body composition of RA patients and thus the recognition of &ldquo;rheumatoid cachexia,&rdquo; in which patients are noted to have a worse prognosis even when the RA appears well controlled. Therefore, the use of DXA in rheumatology is an important tool for detecting osteoporosis, reducing fracture risk and unfavorable outcomes in rheumatological conditions. The widespread use of glucocorticoids and the underlying inflammatory conditions create a need for assessment with DXA. There are complications of conditions found in rheumatology that could be prevented with more widespread patient access to DXA.Keywords: dual-energy X-ray absorptiometry, FRAX, osteoporosis, rheumatology, vertebral fracture assessment, body compositionTanner SBMoore Jr CFDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2012, Iss default, Pp 99-107 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Tanner SB Moore Jr CF A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
description	S Bobo Tanner, Charles F Moore JrDivision of Rheumatology, Vanderbilt University Medical Center, Nashville, TN, USAAbstract: The principal use of dual-energy X-ray absorptiometry (DXA) is to diagnose and monitor osteoporosis and therefore reduce fracture risk, associated morbidity, and mortality. In the field of rheumatology, DXA is an essential component of patient care because of both rheumatologists&rsquo; prescription of glucocorticoid treatment as well as the effects of rheumatological diseases on bone health. This review will summarize the use of DXA in the field of rheumatology, including the concern for glucocorticoid-induced osteoporosis, as well as the association of osteoporosis with a sampling of such rheumatologic conditions as rheumatoid arthritis (RA), systemic lupus erythematosus, ankylosing spondylitis, juvenile idiopathic arthritis, and scleroderma or systemic sclerosis. Medicare guidelines recognize the need to perform DXA studies in patients treated with glucocorticoids, and the World Health Organization FRAX tool uses data from DXA as well as the independent risk factors of RA and glucocorticoid use to predict fracture risk. However, patient access to DXA measurement in the US is in jeopardy as a result of reimbursement restrictions. DXA technology can simultaneously be used to discover vertebral fractures with vertebral fracture assessment and provide patients with a rapid, convenient, and low-radiation opportunity to clarify future fracture and comorbidity risks. An emerging use of DXA technology is the analysis of body composition of RA patients and thus the recognition of &ldquo;rheumatoid cachexia,&rdquo; in which patients are noted to have a worse prognosis even when the RA appears well controlled. Therefore, the use of DXA in rheumatology is an important tool for detecting osteoporosis, reducing fracture risk and unfavorable outcomes in rheumatological conditions. The widespread use of glucocorticoids and the underlying inflammatory conditions create a need for assessment with DXA. There are complications of conditions found in rheumatology that could be prevented with more widespread patient access to DXA.Keywords: dual-energy X-ray absorptiometry, FRAX, osteoporosis, rheumatology, vertebral fracture assessment, body composition
format	article
author	Tanner SB Moore Jr CF
author_facet	Tanner SB Moore Jr CF
author_sort	Tanner SB
title	A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
title_short	A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
title_full	A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
title_fullStr	A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
title_full_unstemmed	A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology
title_sort	review of the use of dual-energy x-ray absorptiometry (dxa) in rheumatology
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/c7c096984eaa4947a063ac4dbeed2bb0
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A review of the use of dual-energy X-ray absorptiometry (DXA) in rheumatology

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