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ORIGINAL ARTICLE
Year : 2020  |  Volume : 11  |  Issue : 1  |  Page : 12-16

Major and minor discordance in dual-energy X-ray absorptiometry diagnosis of osteoporosis – A cross-sectional, population-based, observational study in Indian women


1 Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh; Department of Radio Diagnosis, AIIMS, New Delhi, India
3 Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Tulika Singh
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmh.JMH_117_19

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Objective: The study objective was to evaluate the presence of major and minor discordance in the diagnosis of osteoporosis in a population-based screening program of Indian women using hip and spine dual-energy X-ray absorptiometry (DEXA). Methods: In this institutional review board-approved study, a population-based screening program was offered to women aged > 40 using a mobile van model. A total of 5708 women underwent DEXA between May 2012 and May 2016 as a population-based, opt-in screening program offered to women as an outreach program. Bone mineral density (BMD) was measured at the hip and spine, which was used to derive T-scores and to determine the prevalence of discordance. Results: The densitometry scores were concordant in 42.50% of the cases, with abnormal bone mineral density, whereas in 54.15% of cases, there was minor discordance and major discordance in 3.35% of cases. Body mass index, weight, age, and postmenopausal status of the patient were important predictors of the presence of discordance. Conclusions: Clinicians and epidemiologists should be prepared for at least five out of every ten women screened to have discordance of the T scores at the two anatomical sites scanned. If there is discordance of BMD in underweight persons or in those with low body mass index, then causes other than physiological discordance should be considered, which may be further evaluated.


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