Imaging of Osteoporosis

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Bone Densitometry: 2.75
Patient Care: 1.00
Patient Bone Health, Care, and Radiation Principles: 1.00
Image Production: 0.75
Equipment Operation and Quality Control: 0.75
Procedures: 1.00
DXA Scanning: 1.00

Computed Tomography: 2.00
Image Production: 0.75
Image Formation: 0.75
Procedures: 1.25
Head, Spine, and Musculoskeletal: 1.25

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Musculoskeletal: 0.50

Radiography: 2.25
Procedures: 2.25
Head, Spine and Pelvis Procedures: 2.25

Registered Radiologist Assistant: 4.00
Procedures: 4.00
Musculoskeletal and Endocrine Sections: 4.00

Outline

1. Introduction
2. Definition
3. Epidemiology
4. Etiopathogenesis and Risk Factors
5. Clinical Manifestations
6. Role of Diagnostic Imaging
   1. Conventional Radiography
      1. Axial Skeleton
      2. Appendicular Skeleton
   2. Dual-Energy X-Ray Absorptiometry
      1. Axial DXA
      2. Peripheral DXA
   3. Quantitative CT
      1. Axial Quantitative CT
      2. Peripheral Quantitative CT
   4. Morphometry
   5. Quantitative US
7. New Advances in the Diagnosis of Osteoporosis
8. Differential Diagnosis
9. Current Treatment of Osteoporosis
10. Conclusions

Objectives

Upon completion of this course, students will:

1. know the meaning of osteoporosis and how common it is
2. understand which medical imaging modalities are used to diagnose osteoporosis
3. understand the role of morphometric measurements in diagnosing osteoporosis
4. be familiar with quantitative and semi quantitative techniques for diagnosing osteoporosis
5. understand which two anatomical regions are most susceptible to osteoporotic changes
6. understand the two classifications of osteoporosis
7. compare regional or general osteoporosis to primary or secondary
8. understand the disease processes associated with secondary osteoporosis
9. be familiar with the EVOS study
10. understand quality of life factors for patients with hip fractures
11. know the two classifications of bone
12. understand the composition of bone
13. identify how peak bone mass is obtained
14. understand the factors that contribute to bone mass later in life
15. be familiar with the risk factors for osteoporosis
16. understand bone resorption
17. understand bone formation
18. compare modifiable and non-modifiable risk factors for osteoporosis
19. be familiar with the VERT trial
20. be familiar with a “dowagers” hump
21. understand which anatomical regions are the most common for vertebral fractures
22. identify how conventional radiography is used in the diagnosis of osteoporosis
23. understand what anatomical region is represented by Ward’s area
24. understand what osteopenia is and how it is diagnosed
25. understand the classifications of vertebral spinal fractures
26. be familiar with the Genant classification system of vertebral spinal fractures
27. be familiar with the uses of radiographic absorptiometry (RA)
28. understand the role of DXR in diagnosing osteoporosis
29. understand the Jhamaria index
30. understand the uses of the T and Z-score from a DXA scan
31. understand how the FRAX tool applies to T and Z-scores
32. be familiar with the role of QCT in diagnosing osteoporotic disease
33. understand dual energy techniques
34. describe the roles of pQCT, vQCT, and high resolution CT in diagnosing osteoporotic disease
35. know the advantages and disadvantages of each CT technology used for diagnosing osteoporosis
36. understand how quantitative vertebral morphometry is used in diagnosing spinal vertebral fractures
37. understand the role of QUS in diagnosing osteoporotic disease
38. understand the benefits and disadvantages of QUS in the diagnosis of osteoporosis
39. explain the role of high resolution CT in the diagnosis of osteoporotic disease
40. explain the role of high-resolution MR imaging in the diagnosis of osteoporotic disease
41. understand postmenopausal and senile osteoporosis
42. know what radiographic signs are associated with vertebral spinal disease
43. understand the role of antiresorptive and anabolic pharmacological agents used to treat osteoporosis
44. describe the main surgical interventions used to treat vertebral spinal disorders associated with osteoporosis
45. describe future techniques which can help diagnose osteoporosis while a patient has their mammogram