Emerging Technologies in Osteoporosis Diagnosis

Osteoporosis is a disease defined by diminished bone mass, often resulting in debilitating fragility fractures. As hand surgeons who care for patients with fractures of the distal radius and proximal humerus often related to osteoporosis, it is critical to understand the diagnostic modalities used in the workup of decreased bone density. Although the current reference standard for diagnosing osteoporosis is dual x-ray absorptiometry, this technique has notable drawbacks such as the inability to provide a 3-dimensional image or information about bone microstructure. These limitations result in underdiagnosis of osteoporosis. Other emerging imaging technologies such as quantitative computed tomography, high-resolution peripheral quantitative computed tomography, and quantitative ultrasound offer distinct advantages over dual x-ray absorptiometry. Among these advantages are the production of 3-dimensional images, information about cortical and trabecular microstructure, and reduced radiation exposure. It is essential for hand surgeons to be aware of these evolving diagnostic modalities and the benefits that they offer to provide the best care for patients with osteoporosis.