Ab1606-HPR Is Radiographic Osteopenia a Valid Indication for Bone Densitometry

Background: 'Osteopenia', is a common finding on skeletal radiographs ("Radiographic osteopenia"), and a common indication for Bone Densitometry. Studies have shown osteoporosis on DXA is common in those with radiographic osteopenia. However a significant proportion of patients are not osteoporotic. NICE recommendations are that bone densitometry is not routinely performed without first performing a fracture risk assessment using FRAX. Objectives: We sought to determine the proportion of patients with radiographic osteopenia, who would be diagnosed with osteoporosis on DXA, and whether the DXA scan alters treatment decision in patients with radiographic osteopenia and low pre-BMD FRAX probabilities. Methods: DXA scan reports between 01/08/21 and 28/02/22 were extracted from the radiology information system (n=2997). Those containing the phrase 'radiographic osteopenia' were selected (n=436, 15%). Those with other strong indications for DXA were excluded, leaving 190 reports; a further 4 were excluded where FRAX was unavailable (n=186). The following data was collected or calculated; WHO diagnosis based on lowest T-score; FRAX probability with and without BMD; whether DXA was indicated using FRAX without BMD, Whether treatment was indicated using FRAX with BMD. We aimed to investigate; 1.The proportion of patients with osteoporosis, based on their DXA as per WHO criteria; 2. The proportion of patients, in whom FRAX without BMD would not indicate a DXA, who would be eligible for treatment if DXA was performed. Results: 28% of patients had Osteoporosis, 47% Low Bone Density (Densitometric Osteopenia), and 25% in the normal range, on their DXA scan. Using FRAX without BMD included, DXA was not indicated in 118/186 (63%) of patients. Of these 19/118(16%) had fracture risk high enough to consider osteoporosis treatment if the DXA scan was subsequently performed anyway. Conclusion: 16% of patients with radiographic osteopenia, but with FRAX probabilities not high enough for a DXA to be indicated, would have be eligible for osteoporosis treatment if the DXA was performed anyway and FRAX recalculated with BMD included. It is therefore felt that 'radiographic osteopenia' remains a valid indication for bone densitometry. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.