Assessment of bone density in the distal radius with computer assisted X-ray densitometry (CXD)

A modified and improved radiographic absorptiometry of the distal radius which enables on-site analysis, called computer assisted X-ray densitometry (CXD), was evaluated from the viewpoint of quality assessment. Its precision and the correlation with dual energy X-ray absorptiometry (DXA) was evaluated in 12 volunteers (mean age 44.7 years). The profile of CXD-measured radial bone mineral density (RBMD) from 142 subjects (75 premenopausal and 67 postmenopausal women, mean ages 44.9 and 50.6 years, respectively) were compared with previous data by other methodologies of bone mineral analysis. The intra-assay coefficient of variation (CV) was 0.617%, the inter-assay CV was 2.064%, and the inter-observer CV was 0.673%. The correlation between CXD-measured RBMD and DXA-measured RBMD was of statistical significance (r2 = 0.733, P < 0.01). The correlation of CXD-measured RBMD with age, height or weight corresponded well with previous reports. CXD-measured RBMD and DXA-measured vertebral bone mineral density (VBMD) also had a significant positive correlation, but their correlation was not so close (r2 = 0.149, P < 0.01). The discriminative ability of osteoporosis by CXD was of acceptable level (odd's ratio = 5.72, P < 0.05), when assessed by comparison with bone dystrophy score (BDS) on the plain vertebral radiogram. Although some problems remain in technical standardization, CXD could be an easy, inexpensive, and widely applicable alternative of non-weight bearing cancellous bone densitometry.