Lumbar osteoarthritis, bone mineral density, and quantitative ultrasound

Low bone mass is a major risk factor for osteoporotic fractures. Thus, bone density evaluation, performed by Dual Energy X-ray Absorptiometry (DXA) is important for diagnosis and monitoring treatment of osteoporosis. The accu racy of DXA, particularly at the lumbar spine, can be affected by several f actors such as degenerative diseases. To evaluate the effects of vertebral osteophytosis on densitometric measurements, we examined 198 women, aged 32 -81 years, who had undergone lateral X-ray of the lumbar spine. We classifi ed patients according to different grades of osteophytosis, and evaluated b one density at the lumbar spine and the proximal femur by DXA. We also perf ormed quantitative ultrasound at the heel (QUS). Patients with severe osteo phytosis were significantly older (p<0.0005), and values were adjusted for this parameter. We observed a significant increase in lumbar bone density w ith worsening osteophytosis (p<0.02). On the contrary, no significant diffe rences were found at the femur and QUS. According to bone density at the fe moral neck, we subdivided patients into two groups: osteoporotic (group A) and non-osteoporotic (group B). Both groups showed increasingly high bone d ensity at the spine with worsening osteophytosis (A: p<0.01; B: p<0.02). No differences were found in all the other evaluations In conclusion, lumbar spine measurement is dramatically influenced by osteophytosis, particularly in the elderly. Consequently, other strategies should be performed such as evaluation of the hip and also measurement of the heel by ultrasound, whic h could be an interesting approach in these cases. (C)2000, Editrice Kurtis .