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Plain radiography in the diagnosis of osteoporosis

Authoring team

Conventional radiographs should not be used for diagnosis or exclusion of osteoporosis (1).

Plain radiography may reveal the presence of insufficiency fractures often of the veretebrae or the femoral neck.

Osteoporosis also leads to generalised osteopenia on the X-ray. This feature is however often unreliable as it is dependent upon the penetration of the film and in the early stages of osteoporosis a decreased skeletal radiolucency is not evident until 30% loss of bone mass.

  • when plain films are interpreted as “severe osteopaenia” it is appropriate to suggest referral for DXA (2)

Plain radiography also helps to exclude the presence of bone tumours or other metabolic bone disease.

Reference:

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