Avaliação da qualidade técnica no exame de densitometria óssea

Abstract

INTRODUCTION: The World Health Organization considers bone densitometry (DXA) as the best technique for assessing Bone Mineral Density (BMD). DXA is used in clinical practice as the main diagnostic tool for osteoporosis and fracture risk, however, its performance may present errors that compromise not only its analysis and interpretation, but also decisions regarding the treatment of osteoporosis. OBJECTIVE: Evaluate the frequency and types of errors present in the DXA. MATERIALS AND METHODS: It is a descriptive, observational and cross-sectional study with a quantitative approach and convenience sampling. In the analysis of the DXA exams, the demographic and anthropometric data of the patients and the evaluation of the technical quality of the exams in lumbar spine and proximal femur were evaluated. DXA was categorized as adequate and inadequate due to poor patient positioning, poor image analysis and demographic errors. RESULTS: Of the 123 bone densitometry evaluated, 77 (62.6%) were adequate and 46 (37.4%) were inadequate. The lumbar spine presented inadequacy in 41 (33.4%) of the exams and the proximal femur in 38 (30.9%); inadequacies in the lumbar spine or in the proximal femur were found in eight (6.5%) and in five (4.0%), respectively. The most common inadequacies for lumbar spine were non-centered and rectified lumbar spine and absence of vertebrae when necessary. Regarding the inadequacies found in the proximal femur densitometries, the patient's poor positioning, poor overall hip delimitation and positioning of the region of interest in the femoral neck were observed as being more frequent. CONCLUSION: Of the 123 DXA, 37.4% present at least one error of poor patient positioning or poor analysis of the acquired image, this demonstrates that the orientations determined by the guidelines are not widely adopted, which may contribute to the implications for the monitoring of bone mass.