DXA in the assessment of subchondral bone mineral density in XXXX -A semi-standardized protocol after systematic review.

@entity1 @entity717 @entity626 @entity571
INTRODUCTION: Subchondral bone mineral density (sBMD) contributes to the initiation and progression of @entity626 ( @entity571 ). Reliable methods to assess sBMD status may predict the response of specific @entity571 phenotypes to targeted therapies. While dual-energy X-ray absorptiometry (DXA) of the knee can determine sBMD, no consensus exists regarding its methodology. OBJECTIVE: Construct a semi-standardized protocol for knee DXA to measure sBMD in @entity1 with @entity571 of the knee by evaluating the varying methodologies present in existing literature. METHODS: We performed a systematic review of original papers published in PubMed and Web of Science from their inception to July 2014 using the following search terms: subchondral bone, @entity571 , and bone mineral density. RESULTS: DXA of the knee can be performed with similar reproducibility values to those proposed by the International Society for Clinical Densitometry for the hip and spine. We identified acquisition view, @entity717 , knee positioning and stabilization, ROI location and definition, and the type of analysis software as important sources of variation. A proposed knee DXA protocol was constructed taking into consideration the results of the review. CONCLUSIONS: DXA of the knee can be reliably performed in @entity1 with knee @entity571 . Nevertheless, we found substantial methodological variation across previous studies. Methodological standardization may provide a foundation from which to establish DXA of the knee as a valid tool for identification of SB changes and as an outcome measure in clinical trials of disease modifying osteoarthritic drugs.
