Non-invasive densitometry

Several non-invasive methods are available to measure bone density in different regions of the skeleton. Bedrest and microgravity both lead to bone loss, which is more marked in the lower parts of the skeleton. The bone loss can be monitored by non-invasive techniques in longitudinal studies when precision (i.e. the ability to produce repeated measurements with the same value) is adequate. Bone mineral density (BMD) can be measured with single photon absorptiometry in the lower forearm and calcaneus and with dual energy X-ray absorptiometry (DXA) in almost any region of the skeleton. The latter technique pairs good precision with very low radiation exposure. With peripheral quantitative computed tomography very precise measurements of the lower forearm and tibia are feasible with low radiation dose. It has the additional option of separate measurement of cortical and trabecular bone. This could be of particular importance in microgravity studies, as trabecular bone loss is more severe in this condition. A new development is the measurement of ultrasound velocity or attenuation which depends on bone density and structure. Ultrasound data of the calcaneus correlate well with bone mineral density in spine and hip. The advantage of this technique is that it operates without radiation. However, the clinical value has to be established. The ultimate choice of technique and skeletal region for bone densitometry will depend on specific requirements.