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How does an incidental finding of low bone density on imaging done for another reason inform your screening approach for osteoporosis?
For example, if this comes back in a hand X-ray report, do you generally follow this up with a formal DEXA screening, assuming the patient has not recently had one?
This question is part of our collaboration with ACR Convergence 2025 to Continue the Conversation from the meeting. This question was inspired by the session "Updates in Osteoporosis: Where They 'Fall Short" by Dr. @Sharon Moe and Dr. @Elaine W. Yu. If you did not attend the meeting, information about Convergence On Demand can be found here.
Answer from: at Academic Institution
In patients with CKD, I would also look for changes on the plan radiographs of secondary hyperparathyroidism. For example, erosion of the distal tufts of the phalanges on hand films, erosion of the clavicle, and arterial calcification. If these findings are present, then it signifies hyperparathyroi...
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Answer from: at Community Practice
Usually, the use of “osteopenia” in a hand X-ray is peri-articular, like in RA, and may not reflect generalized low bone mass. It has been estimated in CXR review for a group of radiologists being willing to use the term “osteopenia”, there must be around a 30% decrease in BM...