Schultz Kathryn, Wolf Jennifer Moriatis
Pritzker School of Medicine, University of Chicago, Chicago, IL.
Department of Orthopedic Surgery, University of Chicago, Chicago, IL.
J Hand Surg Am. 2019 Mar;44(3):240-243. doi: 10.1016/j.jhsa.2018.07.006. Epub 2018 Sep 1.
Osteoporosis is a disease defined by diminished bone mass, often resulting in debilitating fragility fractures. As hand surgeons who care for patients with fractures of the distal radius and proximal humerus often related to osteoporosis, it is critical to understand the diagnostic modalities used in the workup of decreased bone density. Although the current reference standard for diagnosing osteoporosis is dual x-ray absorptiometry, this technique has notable drawbacks such as the inability to provide a 3-dimensional image or information about bone microstructure. These limitations result in underdiagnosis of osteoporosis. Other emerging imaging technologies such as quantitative computed tomography, high-resolution peripheral quantitative computed tomography, and quantitative ultrasound offer distinct advantages over dual x-ray absorptiometry. Among these advantages are the production of 3-dimensional images, information about cortical and trabecular microstructure, and reduced radiation exposure. It is essential for hand surgeons to be aware of these evolving diagnostic modalities and the benefits that they offer to provide the best care for patients with osteoporosis.
骨质疏松症是一种由骨量减少所定义的疾病，常导致使人虚弱的脆性骨折。作为手部外科医生，我们治疗的桡骨远端和肱骨近端骨折患者常与骨质疏松症相关，因此了解骨密度降低检查中所使用的诊断方法至关重要。尽管目前诊断骨质疏松症的参考标准是双能X线吸收法，但该技术存在显著缺点，如无法提供三维图像或有关骨微观结构的信息。这些局限性导致骨质疏松症的诊断不足。其他新兴的成像技术，如定量计算机断层扫描、高分辨率外周定量计算机断层扫描和定量超声，相比双能X线吸收法具有明显优势。这些优势包括生成三维图像、提供有关皮质和小梁微观结构的信息以及减少辐射暴露。手部外科医生必须了解这些不断发展的诊断方法及其带来的益处，以便为骨质疏松症患者提供最佳治疗。
