Reliability of the assessment of disc degeneration on the lateral DXA scans - 29/04/21
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Iconographies | 4 |
Vidéos | 0 |
Autres | 0 |
Highlights |
• | DXA spine scans cannot be used to detect thoracolumbar disc degeneration. |
• | The artifacts at the level of vertebrae are related to low resolution of DXA. |
• | Diagnosis of osteoarthritis in the upper thoracic spine is unreliable due to poor visibility. |
Abstract |
Introduction |
Given the prevalence and costs induced by osteoarthritis (OA), it is necessary to find a cheap and safe technique to evaluate it reliably.
Objective |
To assess the value of the lateral dual energy X-ray absorptiometry (DXA) spine scans for the diagnosis of disc degeneration.
Method |
Seventy-seven individuals aged 18 and over, with or without disc degeneration, had both lateral thoracolumbar spine radiographs and DXA spine scans (≤6months between both exams). Disc degeneration was assessed using the Lane score. The images of 20 randomly selected individuals were assessed by two readers.
Results |
Almost 13% of the thoracic levels were not assessable on the DXA scans. For the identification of the intervertebral levels on the DXA scans as interpretable or not, the intra-reader agreement was good (κ=0.81) and the inter-reader agreement was fair (κ=0.27–0.36). For the diagnostic criteria (osteophytes, disc space narrowing, osteosclerosis, overall grade), the intra-reader agreement was excellent for the radiographs (κ=0.89–0.92), good for the DXA scans (κ=0.64–0.83) and fair to moderate for the between-method comparison (κ=0.25–0.44). The inter-reader agreement was moderate to good for the radiographs (κ=0.49–0.66) and fair to good for the DXA scans (κ=0.32–0.74). In the per patient analysis (the most severe grade), the intra-reader agreement was excellent for the radiographs (κ=0.85–0.94), moderate to excellent for the DXA scans (κ=0.53–0.85) and poor to good for the between-methods comparison (κ=0.17–0.63).
Conclusion |
Our results do not support the use of DXA scans for the assessment of thoracolumbar disc degeneration.
Le texte complet de cet article est disponible en PDF.Keywords : Disc degeneration, Vertebral fracture assessment, DXA
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Vol 88 - N° 3
Article 105123- mai 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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