Radiology of Osteoporosis (eBook)

Foreword 5
Preface 6
Contents 7
Introduction to Bone Development, Remodelling and Repair 9
1.1 Introduction 9
1.2 Structure, Cells and Matrix 10
1.3 Bone Development, Remodelling and Regeneration 13
1.4 Regulatory Mechanisms of Development and Function 16
1.5 Local and Systemic Regulation of Bone Remodelling 21
1.6 Discussion of Current Status and Perspectives 25
References 26
Pathophysiology and Aging of Bone 32
2.1 Aging of Bone 32
2.2 Pathophysiology of Osteoporosis 35
2.3 Pathophysiology of Metabolic Bone Diseases Other than Osteoporosis 41
2.4 Conclusion 43
References 43
Pathophysiology of Rheumatoid Arthritis and Other Disorders 50
3.1 Introduction 50
3.2 Epidemiology 51
3.3 Genetics 51
3.4 Etiology 52
3.5 Pathophysiology 52
3.6 Clinical Manifestations 54
3.7 Laboratory Findings 56
3.8 Treatment 56
References 58
Therapeutic Approaches and Mechanisms of Drug Action 60
4.1 Principles of Therapy 60
4.2 Basic Therapeutic Measures 61
4.3 Antiresorptive Drugs 63
4.4 Drugs That Stimulate Bone Formation 67
4.4 Drugs With Dual Action on Bone Formation and Bone Resorption 71
References 71
Orthopedic Surgery 76
5.1 Introduction 76
5.2 Orthopedic Treatment of Osteoporosis 78
5.3 Orthopedic Surgery of Osteoporosis 80
5.4 Osteoporosis as a Complication 82
References 83
Radiology of Osteoporosis 84
6.1 Radiographic Findings in Osteopenia and Osteoporosis 84
6.2 Diseases Characterized by Generalized Osteopenia 88
6.3 Regional Osteoporosis 99
6.4 Quantifying Bone Mineral in Conventional Radiography 100
References 104
Dual- Energy X- Ray Absorptiometry 111
7.1 Introduction 111
7.2 Technical Aspects 112
7.3 Indications 118
7.4 Positioning, Artefacts, and Errors 118
7.5 Interpretation of Results 122
7.6 Applications 123
7.7 Peripheral DXA (pDXA) 125
7.8 DXA in Children and Adjustments for Size Dependency 125
7.9 Conclusions 126
References 126
Vertebral Morphometry 131
8.1 Introduction 131
8.2 Visual Semiquantitative (SQ) Method 132
8.3 Vertebral Morphometry 133
8.4 Comparison Between MRX and MXA 135
8.5 Morphometric Vertebral Fractures 136
8.6 Comparison of Semiquantitative (SQ) Visual and Quantitative Morphometric Assessment of Vertebral Fractures 138
8.7 Instant Vertebral Assessment (IVA) by DXA 139
8.8 Conclusion 140
References 140
Spinal Quantitative Computed Tomography 143
9.1 Introduction 143
9.2 Technique 143
9.3 Interpretation of Data 145
9.4 Comparison with Other Techniques 147
9.5 Dual- Energy QCT 147
References 148
pQCT: Peripheral Quantitative Computed Tomography 149
10.1 Introduction 149
10.2 Bone Densitometry with pQCT 150
10.3 New Applications 159
10.4 Conclusions 164
References 164
Quantitative Ultrasound 169
11.1 Introduction 169
11.2 Basics of Ultrasound Transmission through Bone 170
11.3 Technology of QUS Approaches 170
11.4 Clinical Applications for QUS 176
11.5 Perspectives 177
References 178
Magnetic Resonance Imaging 180
12.2 High- Resolution MRI 180
12.1 Introduction 180
12.3 New Technical Developments 185
12.4 Structure Parameters 186
12.5 Other MR Based Techniques 187
12.6 Conclusion and Future Perspectives 188
References 189
Structure Analysis Using High- Resolution Imaging Techniques 191
13.2 High- Resolution Imaging Techniques 191
13.1 Introduction 191
13.3 Structure Analysis Techniques 198
13.4 Conclusion and Future Developments 198
References 198
Densitometry in Clinical Practice 201
14.1 Introduction 201
14.2 Diagnosis and Prediction of Treatment Outcome 202
14.3 Choice of Technique 204
14.4 Conclusion 205
References 206
Practical Cases 208
Case 1 208
Case 2 209
Case 3 210
Case 4 212
Case 5 214
Case 6 215
Case 7 216
Case 8 217
Case 9 218
Case 10 220
Case 11 220
Case 12 222
Case 13 223
Case 14 224
Case 15 226
Case 16 227
Case 17 228
Case 18 230
Case 19 232
Case 20 234
Case 21 236
References 238
Subject Index 239
List of Contributors 244