“The advantages of REMS technology in the evaluation of BMD in a population with osteoarthritis of the lumbar spine.”

Caffarelli et al, Diagnostics 2024

Carla Caffarelli 1, Antonella Al Refaie 1 Caterina Mondillo 1 Giuditta Manasse 1 Alessandro Versienti 1 Maria Dea Tomai Pitinca 1 Edoardo Conticini 2 Bruno Frediani 2 and Stefano Gonnelli 1

1 Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena,
2 Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena,

This first large study, conducted at the University Hospital of Siena, highlights the clinical utility of REMS technology in assessing the bone status of patients with osteoarthritis. The purpose of this study is to evaluate whether the use of REMS may enhance the identification of osteoporosis in this cathegory of patients. Osteoarthritis at the lumbar level can potentially lead to an overestimation of bone mineral density (BMD) measured with DXA, and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial..

A cohort of five hundred patients with osteoarthritis and with a medical prescription for the DXA examination were enrolled for the study. All patients underwent BMD measurements at lumbar spine and femoral sites by both DXA and REMS techniques. The results showed BMD values measured with DXA at the lumbar spine significantly higher than the BMD values ​​obtained with REMS. The differences were more pronounced in patients with a greater degree of severe osteoarthritis. Furthermore, the percentage of subjects classified as “osteoporotic,” by REMS, was significantly higher than those classified by DXA. The results of this study indicate that, in a population with varying levels of osteoarthritis severity, REMS demonstrated a greater ability to diagnose osteoporosis than DXA. This allows for a more accurate and early diagnosis by consequently improving the quality of life of patients with bone fragility, reducing the likelihood of fractures and the related complications.

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