Because of the presence of radiographic contrast, there is a problem with the edge detection algorithm in the lumbar spine.

Case Description:
Because of the presence of radiographic contrast, there are problems with the edge detection algorithm in the lumbar spine. It will be necessary to clean out the radiographic contrast and then have the patient come for a repeat DXA scan.
Credit:
Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham
References:
- Watts, N.B., Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA). Osteoporos Int, 2004. 15(11): p. 847-54.
- Choplin R.H., Lenchik L and S. Wuertzer, A practical approach to interpretation of Dual-Energy X-ray Absorptiometry (DXA) for assessment of bone density. . Curr Radiol Rep 2(48).
- Dasher, L.G., C.D. Newton, and L. Lenchik, Dual X-ray absorptiometry in today’s clinical practice. Radiol Clin North Am, 2010. 48(3): p. 541-60.
- Theodorou, D.J. and S.J. Theodorou, Dual-energy X-ray absorptiometry in clinical practice: application and interpretation of scans beyond the numbers. Clin Imaging, 2002. 26(1): p. 43-9.
- Mergler, S., et al., Lumbar spine and total-body dual-energy X-ray absorptiometry in children with severe neurological impairment and intellectual disability: a pilot study of artefacts and disrupting factors. Pediatr Radiol, 2012. 42(5): p. 574-83.
- Choi, J.S., The influence of soft tissue recognition errors on BMD value-A case report: Recipient of Young Investigator Award J Clin Densitom, 2012. 15(4): p. 483
- Fuleihan, G.E., et al., Reproducibility of DXA absorptiometry: a model for bone loss estimates. J Bone Miner Res, 1995. 10(7): p. 1004-14.
- Fuerst, T., et al., Quality Assurance in Bone Densitometry in Bone Densitometry and Osteoporosis K. Genant, G. Guglielmi, and M. Jergas, Editors. 1998, Springer Berlin.
- Hansen, K., et al., DXA Errors are Common and Likely Adversely Affect Clinical Care: DXA Quality Improvement is Needed. J Bone Miner Res 2016. 31((Suppl 1) Available at http://www.asbmr.org/ItineraryBuilder/Presentationaspx?pid=83c01c31-237b-4f07-81a5-1eeb2a7968aa&ptag=AuthorDetail&aid=00000000-0000-0000-0000-000000000000. ).
- Promma, S., et al., Errors in Patient Positioning for Bone Mineral Density Assessment by Dual x-ray Absorptiometry: Effect of Technologist Retraining. J Clin Densitom, 2018. 21(2): p. 252-259.
- Cetin, A., et al., Evaluation of the patient positioning during DXA measurements in daily clinical practice. Clin Rheumatol, 2008. 27(6): p. 713-5.
- Staron, R.B., et al., Computerized bone densitometric analysis: operator-dependent errors. Radiology, 1999. 211(2): p. 467-70.
- Baniak, N., S. Grzybowski, and W.P. Olszynski, Dual-energy x-ray absorptiometry scan autoanalysis vs manual analysis. J Clin Densitom, 2014. 17(1): p. 97-103.
