title: Discrepancy in results between spine and hip scans of a woman with end stage renal disease.
abstract: Conditions and artifacts such as aortic calcifications, osteophytes, hip prostheses, and metallic objects can affect the results of dual X-ray absorptiometry scans of the spine and hip. Abdominal surgery often entails the use of metal sutures causing subtle artifacts near or over the lumbar spine resulting in inaccurate bone mineral density (BMD) measurements. We herein report a case of a woman whose spine BMD appeared normal while her hip BMD was > -3.5 SDs. Although the abdominal artifacts create some uncertainty in the diagnosis, renal osteodystrophy is suspect owing to the patient's renal history. This case demonstrates the importance of acquiring scans at two or more sites, closely evaluating scans for artifacts, and obtaining the patient's medical history.
authors.affiliation: Osteoporosis and Arthritis Research Group, Department of Radiology, University of California, San Francisco, CA 94117, USA. mary.sherman@ oarg.ucsf.edu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Sherman
authors.forename: John
authors.initials: J
authors.lastname: Shepherd
authors.forename: Lynda
authors.initials: L
authors.lastname: Frassetto
authors.forename: Harry K
authors.initials: HK
authors.lastname: Genant
mesh_terms: D015502:Absorptiometry, Photon; D016477:Artifacts; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000503:physiopathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008670:Metals; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D013131:Spine / Q000000981:diagnostic imaging*; D013537:Sutures
chemical_list: D008670:Metals