title: BEYOND DXA: ADVANCES IN CLINICAL APPLICATIONS OF NEW BONE IMAGING TECHNOLOGY.
abstract: Dual-energy X-ray absorptiometry (DXA) is generally a very useful tool for assessing bone mineral density (BMD) and fracture risk. However, observational studies have shown that in certain instances, BMD as measured by DXA systematically over- or underestimates fracture risk. We herein describe the clinical conundrums encountered when assessing fracture risk by DXA in patients with primary hyperparathyroidism or type 2 diabetes and those of Chinese ethnicity. Furthermore, we discuss how advanced imaging technology that examines skeletal microarchitecture is furthering our understanding of fracture risk in these clinical situations.
  
  
  BACKGROUND
  BMD = bone mineral density BMI = body mass index BMS = bone material strength BMT = bone microindentation testing 3D = 3-dimensional DM2 = type 2 diabetes mellitus DXA = dual-energy X-ray absorptiometry μFEA = microstructural finite element analysis FRAX = fracture risk assessment tool HRpQCT = high-resolution peripheral quantitative computed tomography ID = indentation distance IDI = indentation distance increase ITS = individual trabecular segmentation PHPT = primary hyperparathyroidism PTH = parathyroid hormone TBS = trabecular bone score.
authors.forename: Monika
authors.initials: M
authors.lastname: Pawlowska
authors.forename: John P
authors.initials: JP
authors.lastname: Bilezikian
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods / Q000639:trends*; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D003952:Diagnostic Imaging / Q000379:methods / Q000639:trends*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed