scholarly journals Comparative studies of bone density by quantitative ultrasound (QUS) with dual-energy X-ray absorptiometry (DEXA) scan

2019 ◽  
Vol 9 (1) ◽  
pp. 8-12
Author(s):  
Alark Devkota Rajouria ◽  
Madur Dev Bhattarai ◽  
Manil Ratna Bajracharya ◽  
Buddha Bahadur Karki
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Quantitative Ultrasound ◽  
Screening Tool ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorp­tiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis. Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius. Results: Significant correlations were observed between QUS and DEXA T score. Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.

scholarly journals Comparison of T-score values obtained by ultrasound osteodensitometry of calcaneus and by dual-energy x-ray absorptiometry scan

2015 ◽  
Vol 68 (9-10) ◽  
pp. 341-346
Author(s):  
Aleksandra Hadziavdic ◽  
Natasa Vajic ◽  
Nikola Gavric
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Metabolic Disease ◽  
Quantitative Ultrasound ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
Female Patients ◽  
T Score ◽  
Significant Difference

Introduction. Osteoporosis is the most frequent metabolic disease of bones. Early detection of pathological loss of bone mineral density represents the first step in prevention, treatment and rehabilitation of osteoporosis. This study was aimed at establishing the correlation of T-score values obtained by ultrasound osteodensitometry of calcaneus with dual-energy x-ray absorptiometry scan. Material and Methods. The study was conducted on the sample of 569 female patients from September 13, 2010 to March 10, 2011. Measurement was made with ultrasound osteodensitometry of ACHILLES make. Quantitative ultrasound method revealed that 77 female patients had a lower value of T-score (osteopenia with risk factors or osteoporosis) and they were referred to T-score measurement with dual-energy x-ray absorptiometry scan. Dual-energy x-ray absorptiometry scanning was performed using LUNAR DPX scanner and 49 female patients were examined. Results. It was concluded that there was no statistically significant difference between T-score values obtained by quantitative ultrasound and dual-energy x-ray absorptiometry scanning. Conclusion. According to this study, it is necessary to provide a greater number of scanners for ultrasound osteodensitometry of calcaneus in order to secure prevention and to refer the patients to further diagnosing on time.

Bone Mineral Density Changes In Patients with Paraproteinemia After Treatment with Bortezomib

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4989-4989
Author(s):  
Tamara Berno ◽  
Kenneth Boucher ◽  
Fenghuang Zhan ◽  
Guido J. Tricot ◽  
Benjamin Mughal ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Disease ◽  
Proteasome Inhibitor ◽  
Mineral Density ◽  
T Score ◽  
The Mean

Abstract Abstract 4989 Background: Bone disease is present at diagnosis in almost all patients with multiple myeloma (MM) and can impact substantially on patient morbidity and quality of life. Decreased bone mineral density is also observed not only in MM but also in patients with monoclonal gammopathy of undetermined significance (MGUS). The pathogenesis of bone disease in MM is complex. The activity of proteasome inhibitor bortezomib has been linked to increased bone formation and osteoblastic activation. Evidence from the available clinical data indicates that bortezomib has a positive impact on bone health in MM and demonstrates a bone anabolic effect. Methods: We analyzed retrospectively 53 patients with MM and 16 with MGUS who have completed bone density at least at diagnosis. 21 patients have completed two bone density (3 MGUS and 18 MM). The bone density was obtained in all patients at baseline and in 16 patients repeated after bortezomib treatement with a median time of bortezomib exposure of 6 months. We analyzed T-score values at lumbar spine and at femoral neck. Results: With a median age of 66 years, 41 male and 28 female were analyzed. At baseline the mean lumbar spine T-score of all subjects and of 16 MM treated with bortezomib was -0.50 and -0.76 respectively. At baseline the mean femoral neck T-score for all subjects and for 16 MM treated with Bortezomib was -1.56 and -1.31 respectively. The baseline mean lumbar spine T-score for MGUS and MM was -0.71 and -0.43 respectively. The baseline mean femoral neck T-score of MGUS and MM was -1.61 and -1.54 respectively. In the group of 16 patients treated with Bortezomib we observed from baseline a change in lumbar bone mineral density T-score of 0.36 and at femoral neck bone density T-score of 0.25. Conclusion: These data show that patients treated with proteasome inhibitor showed moderate increment in bone mineral density at lumbar spine and at femoral neck. Disclosures: No relevant conflicts of interest to declare.

scholarly journals POS1109 MULTIVARIATE ANALYSIS OF RISK FACTORS FOR REDUCED BONE MINERAL DENSITY ASSESSED WITH RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 835.1-835
Author(s):  
Z. Batalov ◽  
M. Nikolov ◽  
N. Nikolov
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Risk Factor ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Body Fat ◽  
Significant Risk ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Background:Radiofrequency echographic multi spectrometry (REMS) is an innovative radiation-free approach for the assessment of bone mineral density (BMD) at axial sites. The principle of this technology is based on the analysis of native raw unfiltered ultrasound signals, the so called radiofrequency ultrasound signals, acquired during an echographic scan of the lumbar spine and/or femoral neck. [1]. A previous published study showed a high degree of correlation between the T-score values provided by the two techniques-REMS and dual energy X-ray absorptiometry for both lumbar spine and femoral neck [2]. REMS software outputs information about BMD (g/cm2), T-scores, Z-scores [standard deviations (SD)], percentage of body fat and basal metabolic rate [BMR (kcal/daily)] [3].Objectives:The aim of the current study is to investigate the multivariate significant risk factors for reduced BMD through REMS technology.Methods:In this study, a total of 273 women with mean age 62 years (yrs.) ± 12 yrs. (range 25-88 yrs.) underwent REMS assessments. Subjects were divided into two groups after acquiring information about the spinal T-scores: 1st group with T-scores ≥-1 SD and 2nd group with T-scores <-1 SD. Age, weight, height, body mass index (BMI), basal metabolic rate (BMR), body fat and menopausal status were the risk factors included in the multivariate statistical analyses. Binary logistic regression was used to assess which are the significant risk factors for T-score <-1 SD. Youden’s indices were calculated for selecting the cut-off points for each risk factor.Results:273 women had mean weight of 70.5 kg. ± 15.7 kg. (range 39.4-127 kg.), mean height 157.1 cm. ± 8.8 cm. (range 100-182 cm.) and mean body mass index (BMI) 28.6 kg/cm2 ± 6.1 kg/cm2 (range 14.9-47.5 kg/cm2). The mean body fat of the subjects was 37.8% ± 8.8% (range 9-52%) and the mean BMR was 1274.01 kcal/daily ± 163.17 kcal/daily (range 929.7-1908.4 kcal/daily). 260 women (95.2%) were attributed to postmenopausal. Age (p=0.000), BMI (p=0.015), menopause (p=0.006) and BMR (p=0.000) were the multivariate significant risk factors for T-score <-1 SD. Odds ratio for the risk factor age was 1.16, so each added year of the women’s age increased the risk for T-score <-1 SD by 1.16%. Women over the age of 65 yrs. showed the highest risk for spinal T-score <-1 SD. The odds ratio of the menopause as a risk factor for spinal T-score <-1 SD was 9.54, so postmenopausal women showed about 9.5 times higher risk of T-score <-1 SD of the lumbar spine than women who still have their period. The increase of BMI by one kg/cm2 decreased the probability of spinal T-score <-1 SD by 0.15% and the increase of BMR by one kcal/daily decreased this probability by 0.02%. Women with BMI above 28.63 kg/cm2 and those with BMR >1331.75 kcal/daily were unlikely to develop spinal T-score <-1 SD.Conclusion:In the current study, multivariate regression analysis was used to develop a specific REMS-based risk prediction model for spinal BMD, corresponding to T-score <-1 SD. Postmenopausal women over age of 65 yrs. with BMI lower than 28.63 kg/cm2 and BMR <1331.75 kcal/daily were at the highest risk for T-score <-1 SD of the lumbar spine.References:[1]Pisani P, Renna MD, Conversano F, Casciaro E, Muratore M, et al. (2013) Screening and early diagnosis of osteoporosis through X-ray and ultrasound-based techniques. World J Radiol 5(11): 398-410.[2]Kirilov N. Analysis of dual-energy x-ray absorptiometry images using computer vision methods. (2020) Trakia Journal of Sciences, Vol. 18, Suppl. 1, pp 114-117.[3]Kirilova E, Kirilov N, Popov I, Vladeva S. (2019) Bone mineral density of lumbar spine and femoral neck assessed by novel echographic approach-Radiofrequency Echographic Multi Spectrometry (REMS). Clin. Cases Miner. Bone Metab., 16 (1), pp. 14-17.Disclosure of Interests:None declared.

scholarly journals Comparison of Bone Mineral Densitometry at 2 Sites Versus 3 Sites in Patients Suspicious for Osteoporosis

2019 ◽  
Vol 12 ◽  
pp. 117954411984901 ◽  
Author(s):  
Ahad Azami ◽  
Hasan Anari ◽  
Manouchehr Iranparvar ◽  
Amin Azizi ◽  
Afshin Habibzadeh
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Femur Neck ◽  
Bone Mineral Densitometry

Objectives: In this study, we aim to evaluate the bone mineral density (BMD) results of 2 standard sites with 3 sites including wrist in diagnosing osteoporosis. Methods: We evaluated the BMD results of 1272 individuals referred for suspected osteoporosis between 2012 and 2015. Those individuals were included with BMD at lumbar spine, femur neck, and wrist. Bone mineral density was measured using a dual-energy X-ray absorptiometry (DXA) device. Bone mineral density and T score were measured for all 3 sites. Results: There was significant correlation between wrist T score with hip T score ( r = 0.606, P < .001) and lumbar T score ( r = 0.527, P < .001). With BMD of 2 sites, patients had osteopenia in 46.3% and osteoporosis in 23.7%, while by adding wrist T-BMD, subjects had osteopenia in 46.6% and osteoporosis in 33%. Between BMD at 2 sites and 3 sites, there was concordance in 81.9%, minor discordance in 17.6%, and major discordance in 0.5%. Conclusions: We observed discordance between BMD measurements of 2 sites and 3 sites, with latter detecting more cases with osteoporosis. In fact, measurement of T scores of wrist along with lumbar and femur neck improves the diagnosis.

scholarly journals Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis

2002 ◽  
Vol 120 (1) ◽  
pp. 09-12 ◽  
Author(s):  
Lúcia Costa Paiva ◽  
Silvana Filardi ◽  
Aarão Mendes Pinto-Neto ◽  
Adil Samara ◽  
João Francisco Marques Neto
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Dual Energy ◽  
X Rays ◽  
Mineral Density ◽  
X Ray ◽  
The Mean

CONTEXT: Measurements of bone density taken by dual-energy x-ray absorptiometry are the most accurate procedure for the diagnosis of osteoporosis. This procedure has the disadvantage of measuring the density of all mineral components, including osteophytes, vascular and extra vertebral calcifications. These alterations can influence bone density results and densitometry interpretation. OBJECTIVE: To correlate radiography and densitometry findings from women with osteoporosis, analyzing the influence of degenerative processes and vertebral fractures on the evaluation of bone density. DESIGN: Retrospective study. SETTING: Osteoporosis outpatients' clinic at Hospital das Clínicas, Universidade Estadual de Campinas. PARTICIPANTS: Ninety-six postmenopausal women presenting osteoporosis diagnosed by bone density. MAIN MEASUREMENTS: Bone mineral density of the lumbar spine and femoral neck were measured by the technique of dual-energy x-ray absorptiometry, using a LUNAR-DPX densitometer. Fractures, osteophytes and aortic calcifications were evaluated by simple x-rays of the thoracic and lumbar spine. RESULTS: The x-rays confirmed vertebral fractures in 41.6%, osteophytes in 33.3% and calcifications of the aorta in 30.2%. The prevalence of fractures and aortic calcifications increased with age. The mean bone mineral density was 0.783g/cm² and the mean T-score was --3.47 DP. Neither fractures nor aortic calcifications had significant influence on bone mineral density (P = 0.36 and P = 0.09, respectively), despite the fractured vertebrae having greater bone mineral density (P < 0.02). Patients with lumbar spine osteophytes showed greater bone mineral density (P = 0.04). Osteophytosis was associated with lumbar spine bone mineral density after adjustment for fractures and aortic calcifications by multiple regression (P = 0.01). CONCLUSION: Osteophytes and lumbar spine fractures can overestimate bone density interpretation. The interpretation of densitometry results should be carried out together with the interpretation of a simple lumbar spine x-ray in elderly women.

scholarly journals Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients

2020 ◽  
Vol 9 (12) ◽  
pp. 3961
Author(s):  
Agnieszka Podfigurna ◽  
Marzena Maciejewska-Jeske ◽  
Malgorzata Nadolna ◽  
Paula Mikolajska-Ptas ◽  
Anna Szeliga ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Replacement Therapy ◽  
Bone Mineral ◽  
Hormone Replacement ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Dxa Scans

Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. Purpose: The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). Materials and methods: This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-β-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. Results: Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm2) vs. 1.150 ± 0.30 g/cm2) (p = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. −0.144 ± 0.82) (p = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; p < 0.001), T-score (−0.75 ± 1.17 vs. −0.59 ± 1.22; p < 0.001), and Z-score (−0.75 ± 1.12 vs. −0.49 ± 1.11; p < 0.001) after the implementation of HRT when compared to pre-treatment results. Conclusions: In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients.

scholarly journals Association between Body Mass Index and Bone Mineral Density in Patients Referred for Dual-Energy X-Ray Absorptiometry Scan in INMAS, Sylhet

2021 ◽  
Vol 22 (2) ◽  
pp. 108-113
Author(s):  
Kamun Nahar ◽  
Mohammed Mehedi Al Zahid Bhuiyan ◽  
Muhammad Sirazul Munir ◽  
Habibur Rahman
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Dual Energy ◽  
Age Group ◽  
Mineral Density ◽  
Left Femur ◽  
X Ray ◽  
T Score ◽  
Pearson's Correlation

With an aging population, osteoporosis is increasingly becoming a public health concern. Bangladesh has a high incidence of osteoporosis and occurs among a relatively younger age group than in the developed world. There are several factors that could be associated with bone mineral density (BMD). We are keen to determine the association with BMD and BMI. The study was carried out on 152 patients who were referred to INMAS for dual energy X- ray absorptiometry (DEXA) measurement of bone mineral density (BMD) during the periods of January 2018 to July 2019. BMD was measured at right femoral neck and lumbar spines. Data about age and sex, BMI were recorded. Reporting was done according to the T score following WHO criteria. Prevalence were compared using chi-squared tests. Among 152 patients, 84.9% were females and 15.1% were males. Results showed for right femur that normal bone density in 91 (59.1%), osteopenia in 54 (35.1%), osteoporosis in 9 (5.8%) and BMD in spine was normal in 57 (37.0%) osteopenia in 44 (28.6%), osteoporosis in 53 (34.4%). About 60% of the study population was normal weight and others were underweighted or overweighed. Status of BMD was associated with BMI in the lumbar spine and femur. In this study group, total 61.2% and 26.3%were found low BMD in spine and right femur respectively. In age group ≥ 60 years, low BMD in spinewas 72.0% that is 42.29% higher compare to below 60 years’ group (50.6%).Correlation of BMI with lumbar spine T score, right femur and left femur T score were measured by Pearson’s correlation coefficient test. Positive significant Pearson’s correlation was observedbetween BMI with spine T score (r = 0.397; p = <0.001), BMI with right femur T score (r = 0.347; p = <0.001) and BMI with left femur T score (r = 0.382; p = <0.001). Bangladesh J. Nuclear Med. 22(2): 108-113, Jul 2019

scholarly journals High-Resolution Peripheral Quantitative Computed Tomography (HR-PQCT) and Dual Energy X-Ray Absorptiometry (DXA) Measurements of Proximal Tibia in Patients Undergoing Total Knee Arthroplasty

2016 ◽  
Vol 101 (1-2) ◽  
pp. 64-69
Author(s):  
Mir Sadat-Ali ◽  
Abdallah S. Al-Omran
Keyword(s):  
Bone Mineral Density ◽  
Total Knee Arthroplasty ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Proximal Tibia ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Total Knee

The aim of the study was to assess bone morphometric indices of the proximal tibia and compare it with bone mineral density (BMD) at hip and lumbar spine and compare with the pQCT. Fifty consecutive patients who underwent total knee arthroplasty (TKA) had a dual energy X-ray absorptiometry (DXA) scan of the upper femur and lumbar spine. Upper tibial cuts were harvested from the tibial condyles and a DXA of tibial cuts was done during TKA. Bone morphometry studies were carried out using HR-pQCT. The bone mineral density at the hip was 0.54 ± 0.08 g/cm2 and spine was 0.73 ± 0.1 with a T score at the hip −2.23 ± 0.44 and spine −2.61 ± 0.45. The bone mineral density of the tibial cut was 0.356 ± 0.03 g/cm2 (P &lt; 0.001) and T score was −6.58 ± 2.87 (P &lt; 0.001). The average bone volume (BV) was 115.27 ± 40.45 mm3, trabecular number (Tb.N) was 1.45 ± 0.32 (1.009–2.37) and trabecular thickness (Tb.Th) was 0.181 ± 0.03 mm (0.111–0.268). The mean bone mineral density measured was 206.24 ± 50.58 mg HA/ccm. This study shows that there is highly significant difference between BMD measured by DXA and pQCT, and that bone morphometric analysis indicates that there is marked decrease in the mechanical properties of the bone in the proximal tibia due to knee Osteoarthritis and Osteoporosis indicating poor bone architecture and quality.

scholarly journals POS0045 LEAST SIGNIFICANT CHANGE IN BONE DENSITOMETRY IN PATIENTS WITH OBESITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 227.2-228
Author(s):  
D. Claire ◽  
M. Geoffroy ◽  
L. Kanagaratnam ◽  
C. Isabelle ◽  
A. Hittinger ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
General Population ◽  
Bone Mineral ◽  
Bone Densitometry ◽  
Dual Energy ◽  
Mineral Density ◽  
Least Significant Change ◽  
X Ray ◽  
Significant Change

Background:Dual energy X-ray absoprtiometry is the reference method to mesure bone mineral density (1). Loss of bone mineral density is significant if it exceeds the least significant change. The threshold value used in general population is 0,03 g/cm2 (2). Patients with obesity are known for having a higher bone mineral density due to metabolism and physiopathology characteristics (3,4).Objectives:The aim of our study was to determine the least significant change in bone densitometry in patients with obesity.Methods:We conducted an interventionnal study in 120 patients with obesity who performed a bone densitometry. We measured twice the bone mineral density at the lumbar spine, the femoral neck and the total hip in the same time (5,6). We determined the least significant change in bone densitometry from each pair of measurements, using the Bland and Altman method. We also determined the least significant change in bone densitometry according to each stage of obesity.Results:The least significant change in bone densitometry in patients with obesity is 0,046g/cm2 at the lumbar spine, 0.069 g/cm2 at the femoral neck and 0.06 g/cm2 at the total hip.Conclusion:The least significant change in bone densitometry in patients with obesity is higher than in general population. These results may improve DXA interpretation in this specific population, and may personnalize their medical care.References:[1]Lees B, Stevenson JC. An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporos Int. mai 1992;2(3):146-52.[2]Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum. oct 2018;85(5):428-40.[3]Shapses SA, Pop LC, Wang Y. Obesity is a concern for bone health with aging. Nutr Res N Y N. mars 2017;39:1-13.[4]Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. juin 2018;17(2):205-17.[5]Roux C, Garnero P, Thomas T, Sabatier J-P, Orcel P, Audran M, et al. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Jt Bone Spine Rev Rhum. janv 2005;72(1):26-31.[6]Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res. août 1999;14(8):1449-56.Disclosure of Interests:None declared.

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