Drawing on the proven qualities of her highly regarded first edition of Bone Densitometry in Clinical Practice: Application and Interpretation, Sydney Lou Bonnick, MD, has thoroughly updated and dramatically expanded this new edition so that family physicians and specialists-radiologists, endocrinologists, rheumatologists, internists, gynecologists, orthopedists, or nephrologists-will fully understand not only what must be done about osteoporosis, but also why. New to this edition-over half the book-are discussions of the clinical guidelines for selecting patients for densitometry measurements, various questionnaires and indices that have been developed to help patients identify themselves as candidates for bone mass measurements, and specific densitometry applications for diagnosis, fracture risk prediction, and monitoring changes in bone density. Thirteen new appendices conveniently locate guidelines, formulas, and reference data needed in daily practice. Updated material includes an expanded review of the effects of diseases and drugs on bone density, new standardization formulas for the hip subregions and forearm, statistical devices necessary to "test the test," and guidance on how to do a short-term precision study and apply the results in clinical practice. A concise but expanded presentation of the statistical concepts that are so important to making the best clinical decisions is included, along with an accompanying CD-ROM containing a Precision Calculator, a Statistical Confidence Calculator for Measured Change in BMD, OST Nomograms, a Patient Risk Factor Questionnaire, and a CME review, which, if successfully completed, makes the user eligible for up to 30 hours of CME Category 1 continuing education credit.
Comprehensive and up-to-date, Bone Densitometry in Clinical Practice: Application and Interpretation, Second Edition offers both primary care physicians and specialists the best means to take part in the growing clinical use of bone densitometry to diagnose and manage osteoporosis.

Klappentext

The second edition of Dr. Sydney Lou Bonnick's text Bone Densitometry in Clinical Practice is an expansion of her highly regarded first edition, which has provided the bone densitometry community with simply the best, most accurate, and most precisely written resource in our field. Dr. Bonnick has applied her very careful and exact scientific approaches to expand and improve on her widely regarded initial text. In addition to the chapters in the first edition on the science of bone densitometry and its clinical appli- tion, this text has new chapters and a CD-ROM that come at a very critical time in our field. The clinical use of bone densitometry is increasing exponentially as more professional societies have endorsements and guidelines on the application of bone densitometry in the assessment and management of osteoporosis. The recent endorsement of population screening by the US Preventive Services Task Force (USPSTF) has now provided g- ernmental validation to this technology, whose proper use Dr. Bonnick has pioneered. In a new chapter, Dr. Bonnick compares the similarities and differences in the recent gui- lines from the USPSTF and the National Osteoporosis Foundation, American Assoc- tion of Clinical Endocrinologists, American College of Obstetrics and Gynecology, and the North American Menopause Society.

Inhalt

Chapter 1: Densitometry Techniques Plain Radiography in the Assessment of Bone Density. Qualitative Morphometry. Qualitative Spinal Morphometry. The Singh Index. Quantitative Morphometric Techniques. Calcar Femorale Thickness. Radiogrammetry. The Radiologic Osteoporosis Score. Radiographic Photodensitometry. Radiographic Absorptiometry. Photon Absorptiometry Techniques. Single-Photon Absorptiometry. Dual-Photon Absorptiometry. Dual-Energy X-Ray Absorptiometry. Peripheral DXA. Single-Energy X-Ray Absorptiometry. Quantitative Computed Tomography. Peripheral QCT. Quantitative Ultrasound Bone Densitometry. References. Chapter 2: Skeletal Anatomy in Densitometry Characterizing the Skeleton in Densitometry. The Axial and Appendicular Skeleton. The Weight-Bearing and Nonweight-Bearing Skeleton. The Central and Peripheral Skeleton. The Trabecular/Cortical Composition of the Skeleton. Forearm Composition. Vertebral Composition. Femoral Composition. All Sites. The Spine in Densitometry. Vertebral Anatomy. Artifacts in PA or AP Spine Densitometry. Vertebral Fractures. Degenerative Changes and Dystrophic Calcification. Effect of Osteophytes on BMD. Effect of Aortic Calcification on BMD. Effect of Facet Sclerosis on BMD. The Vertebral Rotation and PA Lumbar Spine Bone Density. Other Causes of Artifacts in PA and AP Lumbar Spine Studies. The Spine in the Lateral Projection. The Proximal Femur in Densitometry. Proximal Femur Anatomy. Effect of Rotation on BMD in the Proximal Femur. Effect of Leg Dominance on BMD in the Proximal Femur. Effect of Scoliosis, Osteoarthritis, Osteophytes, Surgery, and Fracture on BMD in the Proximal Femur. The Forearm in Densitometry. Nomenclature. Effect of Arm Dominance on Forearm BMD. Effect of Artifacts on BMD in the Forearm. The Metacarpals, Phalanges, and Calcaneus. Bone Physiology. Bone Growth, Modeling, and Remodeling. Bone Modeling. Bone Remodeling. The Basic Multicellular Unit in Bone Remodeling. References. Chapter 3: Statistics in Densitometry The Mean, Variance, and Standard Deviation. The Mean. The Variance and Standard Deviation. Coefficient of Variation. Standard Scores. Z-Scores. T-Scores. Standard Scores on Bone Density Reports. Measures of Risk. Prevalence and Incidence. Prevalence. Incidence. Absolute, Relative, and Attributable Risk. Absolute Risk. Relative Risk. Attributable Risk. Odds Ratios. Confidence Intervals. Accuracy and Precision. Accuracy. Precision. Types of Data. Quantitative Data. Qualitative or Categorical Data. Data and Variables. Correlation. Statistical Significance and the P Value. Regression Analysis. Statistical Evaluations of Diagnostic Tests. Sensitivity and Specificity. Likelihood Ratios. Receiver Operating Characteristic Curves. Regression to the Mean. References. Chapter 4: Quality Control Phantoms. The European Spine Phantom. The Bona Fide Spine Phantom. The Hologic Spine and Hip Phantoms. The Lunar Spine Phantom. Using the Phantom to Create Control Tables and Charts. Shewhart Rules and CUSUM Charts. Shewhart Rules. CUSUM Charts. Automated Quality Control Procedures. Replacing a Densitometer. References. Chapter 5: Bone Density Data: From DPA to DXA and Manufacturer to Manufacturer From DPA to DXA. Hologic DXA and Lunar DPA. Lunar DXA and Lunar DPA. Hologic DXA, Lunar DXA, and Lunar DPA. DXA: From Lunar to Hologic to Norland. Hologic DXA and Norland DXA. Lunar DXA and Hologic DXA. Standardization of Absolute BMD Results. Standardization of Central DXA Absolute BMD Values. Standardization of DXA BMD Results for the Femoral Neck, Trochanter, and Ward's Area. Standardization of Forearm DXA Results. The Utility of the sBMD. From DXA Machine to DXA Machine Within Manufacturers. From Pencil-Beam to Fan-Array DXA Data. Reference Databases. References. Chapter 6: The Effects of Age, Disease, Procedures, and Drugs on Bone Density Age-Related Changes in Bo