Bone Mineral Density Determinations by Dual-Energy X ray Absorptiometry in the Management of Patients with Marfan Syndrome - Some Factors Which Affect the Measurement


Oheneba Boachie-Adjei, MD

Chief Emeritus of Scoliosis Service, Hospital for Special Surgery
Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Orthopedic Surgery, Weill Cornell Medical College

Robert Schneider, MD

Radiation Safety Officer
Attending Radiologist, Hospital for Special Surgery
Associate Professor of Radiology, Weill Cornell Medical College

Cathleen L. Raggio, MD

Assistant Attending Orthopaedic Surgeon, Hospital for Special Surgery

S.W. Burke, MD
Hospital for Special Surgery

P.F. Giampietro, MD, PhD; J.G. Davis, MD; C.M. Mueller, PhD, RD
Weill Medical College of Cornell University

Margaret GE. Peterson, PhD

Abstract
Reduced bone mineral density (BMD) has been sporadically reported in patients with Marfan syndrome. This may or may not place the Marfan patient at increased risk for bone fracture. In comparing the BMDs of our patients with those reported in the literature, it seemed that agreement between values, and hence the degree of osteoporosis or osteopenia reported, was dependent on the instrumentation used. The objective of this study was to statistically assess this impression. BMD measurements from our previously-published study of 30 adults with Marfan syndrome performed on a Lunar DPXL machine were compared with those of studies published between 1993-2000 measured using either Lunar or Hologic bone densitometry instruments. The differences of our measurements compared with those made on other Lunar machines were not statistically significant, but did differ significantly with published results from Hologic machines (P<.001). Before progress can be made in the assessment of BMD and fracture risk in Marfan patients and in the evidence-based orthopedic management of these patients, standardization of instrumental bone density determinations will be required along with considerations of height, obesity, age, and sex.

This article appears in HSS Journal: Volume 3, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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