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Cited by 90Bone health and osteoporosis researchBody Composition Measurement TechniquesClinical Laboratory Practices and Quality Control

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.

An Overlying Fat Panniculus Affects Femur Bone Mass Measurement

Binkley, Neil, Krueger, Diane, Vallarta-Ast, Nellie·2003·Journal of Clinical Densitometry
DOI 10.1385/jcd:6:3:199
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Abstract

Dual-energy X-ray absorptiometry (DXA) is currently the gold standard technique for osteoporosis diagnosis. However, DXA has limitations, including artifacts, such as degenerative disease or metallic foreign bodies, that may confound bone mineral density (BMD) results. Because fat folds overlying the proximal femur may alter soft-tissue density in a nonuniform manner, this may be a currently unappreciated confounder of proximal femur BMD measurement. This possibility was evaluated in 127 patients (52 women/75 men) referred for routine BMD measurement who were identified as having a fat panniculus overlying their proximal femur scan area. Presence of a fat panniculus within the scan field was confirmed by visual assessment of images obtained utilizing a GE Lunar Expert-XL. Subsequently, these individuals were rescanned while retracting their fat panniculus away from the femur scan area without other repositioning between scans. In 49% of the men, and 56% of the women, either the femoral neck, trochanter, or total femur BMD differed by more than the least significant change at our facility. No pattern was observed to predict whether BMD would increase or decrease upon fat retraction. Subsequently, 30 patients were scanned using the standard and retracted technique twice, with repositioning between scans to establish precision. Retracted and standard precision was similar. In conclusion, an overlying fat panniculus may alter proximal femur BMD measurement, which would be expected to impair the ability to accurately diagnose low bone mass and monitor osteoporosis therapy. When a fat panniculus overlays the proximal femur scan area, its retraction should be part of routine densitometric practice.

Overview

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Crossref · 10.1385/jcd:6:3:199

Cites

19 of 19 references verified0 citation errors · 0 not checkable

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Citations

Cites

Research works printed but not linked: 1

  1. Jankowski, 2002, Panniculus adiposus: an unpredictable and often unrecognized source of precision and accuracy errors on DXA scans of the proximal femur, J Clin Densitom, 5, SupplS57

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Metadata

Authors
Binkley, N., Krueger, D., & Vallarta-Ast, N.
Affiliations
  • University of Wisconsin–Madison (US)
  • William S. Middleton Memorial Veterans Hospital (US)
Corresponding author
Binkley, Neil
ORCID
Binkley, Neil
Venue
Journal of Clinical Densitometry
Publisher
Elsevier BV
Published
2003-09
Volume
6
Issue
3
Pages
199-204
ISSN
1094-6950 (ISSN-L)
DOI
10.1385/jcd:6:3:199
OpenAlex
W2016893819
Cited by
90
References
18
Citations by year
2026: 4 · 2025: 5 · 2024: 5 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 11 · 2013: 8 · 2012: 10
FWCI
1.96
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Clinical Densitometry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
  • Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
Keywords
soft tissue artifacts, dual-energy X-ray absorptiometry, osteoporosis diagnosis, measurement precision, femoral neck, trochanter, osteopenia
MeSH terms
Adipose Tissue, Aged, Female, Femur, Humans, Male, Absorptiometry, Photon, Bone Density, Artifacts

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