Evaluation of the patient positioning during DXA measurements in daily clinical practice

For prompt diagnosis of osteoporosis, properly instructed dual-energy X-ray absorptiometry (DXA) measurements are required. To get correct DXA results in addition to quality control procedures, proper positioning of specific body regions such as hip and spine should also be achieved. The aim of this study was to assess the accurateness of the patient positioning for hip and spine regions in daily clinical practice. Hip and spine scan images of 113 DXA reports were evaluated for whether or not the patient was positioned correctly. Out of 113 hip and spine DXA reports, 61 hips and 94 spines were found to have scan images with improper positions. The spine was not straight in 48.7% of the images. The 38.9% of the spinal images did not comprise both iliac crests, and 40.7% did not include T12 and L5 vertebrae. In hip DXA reports, 40.7% of the femoral shaft was deviated to one side. We found the ratio of invalid positions surprisingly very high. Although this may stem from local technical problems and may not reflect the overall quality of scans in other centers, such misinterpretations would definitely affect clinicians' decisions in an inappropriate way. We suggest that relevant inconveniences should be kept in mind both by the clinicians and the technical staff for better production and prompt estimation of DXA measurements.