Precision of dual energy x-ray absorptiometry in the upper extremities

Dual energy x-ray absorptiometry (DEXA) has been shown to be a precise method for measuring bone mineral density (BMD) and content (BMC) in lumbar spine and proximal femur, but it has not been widely used in other skeletal sites. The in vivo day-to-day precision of DEXA (Norland XR-26) for seven anatomic sites in the upper extremities was evaluated by twice measuring both the right and left sides in ten subjects. For consistently defined regions-of-interest, the following precision values (coefficient of variation) were obtained for BMD and BMC: 0.8% and 1.0% (proximal humerus); 0.5% and 0.5% (humeral shaft); 0.7% and 0.5% (radial shaft); 1.3% and 1.1% (ulnar shaft); 0.7% and 1.0% (distal radius); 0.7% and 1.2% (distal ulna); 0.4% and 0.6% (hand). The initially observed relative side-to-side differences did not change significantly in the repeated measurements. Our results indicate that DEXA is a precise method for assessment of BMD and BMC also in the upper extremities.