Feasibility of Osteoporosis Screening by Dual-Energy Radiographic Absorptiometry of the Phalanx

A new dual-energy radiographic absorptiometry-based technique is presented as a cost-effective method for mass osteoporosis screening. Designed for use in a dental health care setting, we propose a method and device for bone mineral density (BMD) assessment using the middle phalanx of the 3rd digit as our anatomical measurement site. Our 2-staged project includes the development of the prototype to carry out the measurement and the execution of a small pilot study to determine the efficacy of the method and device. Fifty subjects from the general adult population (age range: 25-82 yr), wherein 10 normal subjects (5 females and 5 males) and 40 target group subjects (30 females and 10 males) who were at risk for osteoporosis (as assessed qualitatively through questionnaire responses) were evaluated with our method. The BMD values obtained from the normal and target groups were significantly different (p < 0.0001). Phantom measurements to determine the bias and coefficient of variation of the technique yielded values of 1.9% and 7%, respectively. The proposed technique could provide a relatively inexpensive and widely available means for mass osteoporosis screening. Further validation of this method, to include comparison to a gold standard, such as dual-energy X-ray absorptiometry, is warranted.