Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 2

Comparison of Phalangeal Absorptiometry Technique with Dual Energy X-Ray Absorptiometry Technique in the Diagnosis of Osteoporosis

Berrin HÜNER 1 ,Mehmet Hayri Özgüzel 2 ,Sevgi Atar 2
1 Clinic of Physical Medicine and Rehabilitation, İstanbul Okmeydanı Training and Research Hospital, İstanbul, Turkey
2 Sağlık Bakanlığı Okmeydanı Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul

Objective: Osteoporosis causes considerable burden to the economy and decreases patients’ quality of life, leading to vertebral and non-vertebral fractures. We aimed to research the comparability of the results of bone mineral density (BMD) by using phalangeal absorptiometry (PA), a cheaper and  more practical method in osteoporosis screening, with dual energy X-ray absorptiometry (DXA).

Materials and Methods: BMD scores of 172 postmenopausal women were obtained by DXA technique, applied to lumbar and femoral neck region, and by PA - to non-dominant hand. Patients with vertebral fracture were ascertained via Kleerekoper method. The relation of BMD values obtained by both techniques was evaluated with Kappa correlation tests. Patients were groupped  as follows: with osteoporosis, osteopenia, and with fracture and without fracture; and then intraclass correlations were assessed. 

Results: Mean age of the patients was 60.56±7.65 (44-83). The consistency of DXA and PA with osteoporosis, osteopenia was found to be statistically significant by using the Kappa test (p=0.0001, p=0.001). When t scores measured by DXA and PA were compared in whole patient population, positive estimating value in femur neck was 0.75, accuracy value 0.67 and LR(+) Likelihood Ratio value was 1.55. For L1-4 t scores, the same parameters were 0.89, 0.72, 2.00 and for L2-4 t scores were 0.90, 0.72, 2.08, respectively. When these two techniques were compared only in the patient population with osteoporosis, positive estimating value in femur neck was 0.52, accuracy value 0.73 and LR(+) value was 2.67. For L1-4 and L2-4, LR(+) value raised up to 4.27. In the osteopenic patients positive estimating values in femur neck, L1-4 and L2-4 were found as 0.73, 0.77, 0.78, accuracy values as 0.63, 0.60, 0.59 and LR(+) values as 1.88, 2.07 and 1.97, respectively.  

Conclusion: We suggest that PA technique can be used safely in population screening for osteoporosis. 

Keywords : Osteoporosis, phalangeal absorptiometry, dual energy X-ray absorptiometry