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Aortic calcification contributing to bone densitometry measurement.
J A Smith1, J A Vento, R P Spencer
1Division of Endocrinology, Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030-2804, USA.
Summary
Aortic calcifications can significantly inflate lumbar bone density measurements, potentially leading to osteoporosis misdiagnosis. This finding is crucial for accurate bone mineral density assessment in elderly patients.
Area of Science:
- Gerontology
- Radiology
- Endocrinology
Background:
- Glucocorticoid therapy in asthma patients necessitates bone mineral density assessment for osteoporosis.
- Elderly individuals are at higher risk for osteoporosis and aortic calcification.
Observation:
- A 75-year-old male asthmatic on glucocorticoids presented with findings suggestive of osteoporosis.
- Lumbar spine radiography revealed vertebral osteopenia, scoliosis, and a highly calcified abdominal aorta.
- Dual-energy X-ray absorptiometry (DXA) showed low bone mass but an abnormal pattern due to aortic calcification.
Findings:
- A calcified aorta contributed up to 33% of the measured lumbar bone density (L2-L4).
- Lateral DXA measurements confirmed the aorta's density was comparable to the L2 vertebra.
- This aortic contribution to bone density is higher than previously reported.
Implications:
- Aortic calcifications can lead to significant overestimation of lumbar bone density.
- Failure to recognize aortic calcification may result in misclassification of osteoporosis.
- Accurate interpretation of DXA scans requires consideration of vascular calcifications.