Assessment of osteoporosis: comparison of radiographic absorptiometry of the phalanges and dual X-ray absorptiometry of the radius and lumbar spine.

Purpose: To evaluate radiographic absorptiometry (RA) of the phalanges in healthy women and in women with osteoporosis and to compare the results of RA with those of dual x-ray absorptiometry (DXA) of the radius and spine.
Materials and Methods: Thirty-two healthy premenopausal women, 39 healthy postmenopausal women, and 35 postmenopausal women with osteoporosis underwent RA of the phalanges and DXA of the radius and lumbar spine. Pairwise comparisons, age-related bone losses, and percentage decrements and Student t values for intergroup discrimination were calculated. The ability to identify patients with osteoporotic fractures was evaluated by using receiver operating characteristic and age-adjusted logistic regression analyses. The diagnostic agreement for osteoporosis was assessed with kappa statistics.
Results: Findings from RA were correlated with those from spinal DXA (r = .56). The annual bone losses in healthy women, as measured with RA, radial DXA, and spinal DXA, were 0.47%, 0.47%, and 0.32%, respectively. Intergroup percentage decrements and t values obtained with RA were comparable to those obtained with radial and with spinal DXA. Receiver operating characteristic analysis showed no statistically significant differences. The odds ratios for RA, radial DXA, and spinal DXA were 2.1, 1.9, and 2.4, respectively. The kappa scores were 0.44 for both RA versus radial DXA and RA versus spinal DXA, and the score was 0.22 for radial DXA versus spinal DXA.
Conclusion: RA appears to be a useful technique for assessing age- and menopause-related bone loss and for identifying women with osteoporosis.