Plain radiographs can be useful in estimating lumbar bone density.
On standard lateral roentgenograms of the lumbar spine, a decrease in bone density is said to be detectable only after a bone loss of about 40%. To evaluate this view, we compared findings on plain films with bone mineral content of L1 determined by quantitative computed tomography in 80 healthy subjects with a mean age of 60 years. The highest correlations with bone mineral content were found for the criteria "vertebral density versus soft tissue" (r = 0.5, p less than 0.0001), the "amount of trabeculations" (r = 0.49, p less than 0.0001), and for the "overall" estimate of osteopenia in the vertebra (r = 0.55, p less than 0.0001). Surprisingly, these three radiographic criteria proved to be most helpful in subjects with bone mineral content above 110 mg/cm3 (nonosteoporotic range). We conclude that lateral radiographs of the lumbar spine can provide a rough estimate of bone density in nonosteoporotic subjects which may be helpful in determining when further analysis with more precise methods is appropriate.
Department of Medicine, Stanford University School of Medicine, CA.
B A
BA
Michel
N E
NE
Lane
H H
HH
Jones
J F
JF
Fries
D A
DA
Bloch
D015519:Bone Density; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000378:metabolism; D012016:Reference Values; D012680:Sensitivity and Specificity; D013131:Spine / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed