Bone Densitometry: Patients with Asymptomatic Primary Hyperparathyroidism. HealthTechnology Assessment Number 6, 1996

摘要

Bone mass loss and osteoporosis are caused by various conditions, such asasymptomatic primary hyperparathyroidism (APHPT), and treatments, such as prolonged steroid therapy. Bone densitometry is used to measure bone mass density to determine the degree of osteoporosis and fracture risk. Bone densitometers measure the radiation absorption by the skeleton to determine bone mass of the peripheral, axial, and total skeleton. Common techniques include single-photon absorptiometry (SPA) of the forearm and heel, dual-photon (DPA) and dual-energy x-ray absorptimetry (DXA) of the spine and hip, qualitative computed tomography (QCT) of the spine or forearm, and radiographic absorptiometry (RA) of the hand. Part I of this report addresses important technical considerations of bone densitometers, including radiation dose, site selection, and accuracy and precision, as well as cost and charges. Part II evaluates the clinical utility of bone densitometry in the management of patients with mild primary hyperparathyroidism. Primary hyperparathyroidism (PHPT) is a generalized disorder of calcium, phosphate, and bone metabolism due to excessive secretion of parathyroid hormone from the parathyroid gland(s). Issues addressed are the type and extent of bone loss in these patients, whether they have an increased risk for fracture, and whether parathyroidectomy reduces the risk of fracture. Subsequent assessments address the clinical utility of bone densitometry for steroid-dependent patients, estrogen deficient women, patients with vertebral abnormalities, and end-stage renal disease patients.