Edge Detection, Scoliosis

Case Description:

A patient with severe scoliosis had DXA performed as part of spine surgery planning.  The DXA report listed a lowest T-score of -5.2 in the L1-L4 ROI. Otherwise, the lowest T-score of the hip regions was -1.4. Spine surgery was delayed until the patient could see a bone health specialist. After review of the images, the edge detection did not abut the bones and included soft tissues artificially lowering the BMD measured. Secondarily, there is so much structural change from the scoliosis that the lumbar spine is not a usable site for DXA diagnostics.

Credit:

Alvin Lee Day, MD
University of South Carolina School of Medicine