Radiographic absorptiometry of the phalanges as a screening instrument to detect osteoporosis of the hip.
OBJECTIVE
To determine the validity of radiographic absorptiometry (RA) of the phalanges in detecting osteoporosis of the femoral neck, measured by dual energy X-ray absorptiometry (DXA).


METHODS
In a group practice, 494 Caucasian women aged 55 to 84 years were recruited. Hand radiographs and DXA measurements of the hip were performed in 449 women. 409 (91.1%) hand radiographs had sufficient quality for analysis by RA. Change of bone mass by age was obtained by using linear regression. Correlations between RA and DXA were calculated. Sensitivity and specificity of RA were calculated for several RA cut-off levels.


RESULTS
The mean bone mineral density at the femoral neck was 0.866 g/cm2 and 92.57 arbitrary units at the phalanges. A moderate correlation of 0.53 (p<0.01) was found between RA and DXA. Depending on the cut-off level used, the sensitivity and specificity of RA in detecting osteoporosis at the femoral neck was 0.84-0.55 and 0.61-0.88, respectively.


CONCLUSIONS
RA may be used as a screening technique to detect osteoporosis, but confirmation is necessary in the subgroup with a positive outcome on RA.
Department of General Practice, Leiden University Medical Centre, The Netherlands.
R G
RG
Versluis
F J
FJ
Vismans
C M
CM
van de Ven
M P
MP
Springer
H
H
Petri
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000378:metabolism; D005385:Fingers / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity