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Published on: January 29, 2018
A reliable method for measuring proximal tibia and distal femur bone mineral density using dual-energy X-ray
Arjan J T Bakkum1, Thomas W J Janssen1, Marijn P Rolf2
1Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands; Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
Purpose:
To assess the intra- and inter-rater reliability of a standardized protocol for measuring proximal tibia and distal femur bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA).
Methods:
Ten able-bodied individuals (7 males) participated in this study. During one measurement session, the knee of each participant was scanned twice by rater 1 using DXA. Both scans were analyzed twice by rater 1 as well as once by a second rater. Intraclass correlation coefficients (ICCs), standard error of measurements (SEMs) and smallest detectable differences (SDDs) were calculated for the outcome measures proximal tibia and distal femur BMD. A decision study was performed to determine the effect of study protocol adjustments (i.e. increasing the number of scan repetitions, or scan analyses by the same rater) on SEM and SDD values.
Results:
High intra- and inter-rater ICCs (0.97-0.98) were found for both proximal tibia and distal femur BMD. Low SEMs (0.017-0.028 g/cm(2)) and SDDs (0.047-0.077 g/cm(2)) were found, with a slightly better result for proximal tibia BMD. Increasing the number of scan analyses by the same rater did not markedly reduce SEM and SDD values, while increasing the number of scan repetitions did.
Conclusions:
Proximal tibia and distal femur BMD can be reliably assessed with this method.
