The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine

BACKGROUND

Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis.

METHODS

A cohort of 500 patients (mean age: 63.9 ± 11.2 years) diagnosed with osteoarthritis and having a medical prescription for dual-energy X-ray absorptiometry (DXA) were recruited for the study. All patients underwent BMD measurements at lumbar spine and femoral sites by both DXA and REMS techniques.

RESULTS

The T-score values for BMD at the lumbar spine (BMD-LS) by DXA were significantly higher with respect to BMD-LS by REMS across all OA severity scores, and the differences were more pronounced in patients with a higher degree of OA severity (p < 0.001). Furthermore, the percentage of subjects classified as "osteoporotic", on the basis of BMD by REMS was markedly higher than those classified by DXA, both when considering all skeletal sites (39.4% vs. 15.1%, respectively) and the lumbar spine alone (30.5% vs. 6.0%, respectively). A similar pattern was observed when OA patients were grouped according to the Kellgren-Lawrence grading score.

CONCLUSIONS

The findings from our study indicate that, in a population with varying severity levels of osteoarthritis, REMS demonstrated a higher capability to diagnose osteoporosis compared to DXA, and this could lead to earlier intervention and improved outcomes for patients with bone fragility, reducing the likelihood of fractures and associated complications.

Osteoporosis and major fragility fractures (MOF) in sarcoidosis patients: association with disease severity

BACKGROUND

The reports on bone mineral loss or major osteoporosis fracture (MOF) in sarcoidosis are scarce and have conflicting outcomes. This study aimed to evaluate the prevalence and risk factors of MOF in sarcoidosis patients.

METHODS

In a single-center cohort of 382 patients with sarcoidosis (55.8 ± 11.6 years) we evaluated bone mineral density at lumbar spine, at femoral neck and at total hip and the presence of MOF. Lung function measurements including diffusion capacity for carbon monoxide (DLCO) were assessed. Chest X-rays were performed and radiological staging was done by Scadding score.

RESULTS

Ninety patients (23.6%) with sarcoidosis have history of a MOF. BMD T-scores were lower in sarcoidosis with MOF with respect to those without MOF, but the difference was statistically significant only for BMD at femoral neck (p < 0.05). Moreover, BMD values at total hip was positively correlated with DLCO (%) (p < 0.001). Prevalence of MOF was higher in patients with sarcoidosis with lung parenchymal involvement (radiological stages 2-4) than in patients with sarcoidosis in chest X-ray stages 0 and 1 (28.3 vs 19.2% respectively, p < 0.05). Moreover, multiple regression analyses showed that X-ray Scadding score was positively associated with MOF.

CONCLUSIONS

This study shows that MOF represent a common and important complication in patients with moderate/severe sarcoidosis. The chest X-ray evaluation and the pulmonary function test could allow to define the risk of MOF in sarcoidosis patients.

Radiofrequency Echographic Multispectrometry (REMS): A New Option in the Assessment Bone Status in Adults with Osteogenesis Imperfecta

This study aimed to estimate the utility of the Radiofrequency Echographic Multispectrometry (REMS) approach in the assessment of bone mineral density (BMD) in subjects with osteogenesis imperfecta (OI). In 41 subjects (40.5 ± 18.7 years) with OI and in 36 healthy controls, we measured BMD at the lumbar spine (LS-BMD), femoral neck (FN-BMD) and total hip (TH-BMD), employing a dual-energy X-ray absorptiometry tool. Additionally, REMS scans were also performed at the lumbar and femoral sites. The presence and number of reported fractures were assessed in the study population. Patients characterized by a history of fragility fractures represented 84.5% of the study population. OI subjects showed significantly reduced BMD values both at the level of the lumbar spine and the femoral subregions (p < 0.01) compared to healthy controls when performed using both the DXA and the REMS method. Dividing OI patients on the basis of the Sillence classification, no differences were found between the LS-BMD values carried out using the DXA technique between the OI type I group and OI Type III and IV groups. On the contrary, the OI Type III and IV groups presented significantly lower values of both Trabecular Bone Score (TBS) and LS-BMD through REMS with respect to OI type I patients (p < 0.05). Based on the data of this study, it is possible to conclude that even the new REMS assessment, which does not use ionizing radiation, represents an excellent method for studying the bone status in subjects affected by OI.