Opportunistic Screening for Osteoporosis Using Computed Tomography: State of the Art and Argument for Paradigm Shift

Leon Lenchik, Ashley A. Weaver, Robert J. Ward, John M Boone, Robert D Boutin

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Purpose of Review: Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to “opportunistically” screen for osteoporosis, without additional cost or radiation exposure to patients. This review examines the role of opportunistic CT in the evaluation of osteoporosis. Recent Findings: Recent evidence suggests that opportunistic measurement of bone attenuation (radiodensity) using CT has sensitivity comparable to DXA. More importantly, such an approach has been shown to predict osteoporotic fractures. Summary: The paradigm shift of using CTs obtained for other reasons to opportunistically screen for osteoporosis promises to substantially improve patient care.

Original languageEnglish (US)
Article number74
JournalCurrent Rheumatology Reports
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2018

Keywords

  • Computed tomography
  • Fracture
  • Opportunistic screening
  • Osteoporosis

ASJC Scopus subject areas

  • Rheumatology

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