Radiographic absorptiometry as a screening tool in male osteoporosis: results from the Odense Androgen Study.
BACKGROUND
Osteoporosis screening with dual-energy absorptiometry (DXA) is not recommended due to low diagnostic utility and costs. Radiographic absorptiometry (RA) determines bone mineral density (BMD) of the phalangeal bones of the hand and is a potential osteoporosis pre-screening tool.


OBJECTIVE
To determine the ability of RA to identify patients with osteoporosis in a male population.


METHODS
As part of the Odense Androgen Study, we measured BMD of the intermediate phalanges of the second to fourth finger, lumbar spine (L2-L4), and total hip in 218 men aged 60-74 years (mean 68.8 years), randomly invited from the population, using RA (MetriScan) and DXA (Hologic 4500-A). Osteopenia and osteoporosis were defined as a T-score of less than -1.0 and -2.5, respectively, in the hip and/or lumbar spine. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were computed.


RESULTS
BMD(RA) of the phalanges correlated significantly with BMD(DXA) of the hip (R=0.47, P<0.001) and lumbar spine (R=0.46, P<0.001). A total of 105 men (48.2%) were osteopenic and 15 (6.9%) osteoporotic. The AUC (SE) value for detecting osteoporosis was 0.75 (0.06). The sensitivity and specificity of RA in identifying osteoporosis were 0.93 and 0.50, respectively.


CONCLUSIONS
BMD(RA) correlated weakly with BMD(DXA) of the lumbar spine and total hip, and RA has a moderate ability to identify osteoporotic individuals. Nevertheless, RA may be used as a pre-screening tool in men, since the diagnosis may be ruled out in half the population at little cost.
Hansen
S J
SJ
Department of Endocrinology, Odense University Hospital, Kloevervaenget 6.3, Odense, Denmark. stinus.hansen@ouh.regionsyddanmark.dk
Nielsen
M M F
MM
Ryg
J
J
Wraae
K
K
Andersen
M
M
Brixen
K
K
D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D015519:Bone Density; D015331:Cohort Studies; D003718:Denmark; D050278:Finger Phalanges / Q000000981:diagnostic imaging; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity