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First Published in 1981, this book offers a full, comprehensive guide to measuring bone mass. Carefully compiled and filled with a vast repertoire of notes, diagrams, and references this book serves as a useful reference for students of osteology, and other practitioners in their respective fields.
Bone densitometry (BD) is an extraordinary clinical tool. It provides a safe, non-invasive window to the skeleton. Through that window, a physician can obtain vital clinical information that enhances diagnosis and improves patient management. Further, much has changed in the last decade to make bone densitometry the especially fascinating field of medicine it is today, incorporating imaging, physics, quantitative analysis, statistics, and computer technology -- all applied in the diagnosis and management of osteoporosis. No text details the state-of-the-art and value of densitometry better than Bone Densitometry in Clinical Practice: Applications and Interpretation, Third Edition. Written by renowned expert Sydney Lou Bonnick, MD, this edition improves remarkably on her highly regarded previous volumes, with a significant update and expansion of material. New chapters reflect densitometry’s growing applications as well as the evolving needs of the densitometrist. New material on radiation safety and assessment for secondary causes of bone fragility is included, and the text also incorporates material from the recent ISCD Position Development Conferences (PDC’s), both the 4th adult and the 1st pediatric. Moreover, an entire appendix devoted to the PDCs has been added, providing solutions to many unanswered questions concerning bone densitometry applications. Comprehensive and invaluable, Bone Densitometry in Clinical Practice: Application and Interpretation, Third Edition offers all primary care physicians and specialists the ideal reference for practicing state-of-the-art bone densitometry and caring for patients with, or at risk for, osteoporosis.
The second edition of Dr. Sydney Lou Bonnick’s text Bone Densitometry in Clinical Practice is an expansion of her highly regarded first edition, which has provided the bone densitometry community with simply the best, most accurate, and most precisely written resource in our field. Dr. Bonnick has applied her very careful and exact scientific approaches to expand and improve on her widely regarded initial text. In addition to the chapters in the first edition on the science of bone densitometry and its clinical appli- tion, this text has new chapters and a CD-ROM that come at a very critical time in our field. The clinical use of bone densitometry is increasing exponentially as more professional societies have endorsements and guidelines on the application of bone densitometry in the assessment and management of osteoporosis. The recent endorsement of population screening by the US Preventive Services Task Force (USPSTF) has now provided g- ernmental validation to this technology, whose proper use Dr. Bonnick has pioneered. In a new chapter, Dr. Bonnick compares the similarities and differences in the recent gui- lines from the USPSTF and the National Osteoporosis Foundation, American Assoc- tion of Clinical Endocrinologists, American College of Obstetrics and Gynecology, and the North American Menopause Society.
Precision and accuracy are terms that are used in quantitative scientific fields to describe the reproducibility of a measurement or the capacity of a measurement to quantify the actual biological matter present. Precision and accuracy are also important applications in the quality control and quality assurance of the performance and interpretation of bone mass measure ments. Precision and accuracy also reflect the values and qualities of the author of this important text in the clinical application of bone densitometry. This is the first textbook of its kind devoted entirely to the proper use of this technology in the practice of medicine. Dr. Sydney L. Bonnick has devoted a majority of her career helping to define excellence in this exploding area and in doing so, has earned the respect and admiration of the international bone densitometry community. Confusion abounds in this field due to the proliferation of bone densito metry devices, including the various models that can measure many skel etal sites, the different normative data bases used, and the establishment of diagnostic categories of low bone mass. Dr. Bonnick's authoritative and carefully referenced text will certainly clarify and broaden the knowledge of those physicians who currently perform bone densitometry. This text is designed to be utilized by a wide range of medical specialists: endocrinolo gists, rheumatologists, gynecologists, radiologists, orthopedic surgeons, and nephrologists.
Drawing on the proven qualities of her highly regarded first edition of Bone Densitometry in Clinical Practice: Application and Interpretation, Sydney Lou Bonnick, MD, has thoroughly updated and dramatically expanded this new edition so that family physicians and specialists-radiologists, endocrinologists, rheumatologists, internists, gynecologists, orthopedists, or nephrologists-will fully understand not only what must be done about osteoporosis, but also why. New to this edition-over half the book-are discussions of the clinical guidelines for selecting patients for densitometry measurements, various questionnaires and indices that have been developed to help patients identify themselves as candidates for bone mass measurements, and specific densitometry applications for diagnosis, fracture risk prediction, and monitoring changes in bone density. Thirteen new appendices conveniently locate guidelines, formulas, and reference data needed in daily practice. Updated material includes an expanded review of the effects of diseases and drugs on bone density, new standardization formulas for the hip subregions and forearm, statistical devices necessary to test the test," and guidance on how to do a short-term precision study and apply the results in clinical practice. A concise but expanded presentation of the statistical concepts that are so important to making the best clinical decisions is included, along with an accompanying CD-ROM containing a Precision Calculator, a Statistical Confidence Calculator for Measured Change in BMD, OST Nomograms, a Patient Risk Factor Questionnaire, and a CME review, which, if successfully completed, makes the user eligible for up to 30 hours of CME Category 1 continuing education credit. Comprehensive and up-to-date, Bone Densitometry in Clinical Practice: Application and Interpretation, Second Edition offers both primary care physicians and specialists the best means to take part in the growing clinical use of bone densitometry to diagnose and manage osteoporosis."
Bone Densitometry in Growing Patients: Guidelines for Clinical Practice, edited by Drs. Sawyer, Bachrach, and Fung, is a milestone book for all health prof- sionals concerned with bone health in growing patients. The book introduces and emphasizes the importance of attending to issues of bone health and development in childhood and adolescence as a way of maintaining such health and decreasing the epidemic of osteoporosis that we are now seeing in older adults. In doing so, the book offers a much-needed first set of standards of bone densitometry in growing patients. Given the numerous reports of serious interpretation errors in densitometry results in children, the development of this body of work is truly important. It is in this context that Bone Densitometry in Growing Patients: Guidelines for Clinical Practice presents the current evidence, including an assessment of the strengths and weaknesses in the data on assessing bone density in childhood and adolescence. In short, the editors and authors have done an outstanding job of or- nizing not only the key topics in this broad clinical discussion, but also, and most importantly, the evidence within these areas.
The study of bone microarchitecture is flourishing because of a recent shift in perspective that has taken researchers beyond utilizing bone mineral density as the primary source of information about certain matters related to bone. In the area of osteoporosis and skeletal changes, bone mineral density (BMD) is widely used for screening, monitoring and assessing therapeutic efficacy, and yet, it is currently accepted that BMD does not fully explain the pathogenesis of osteoporosis, the process of aging, nor mechanisms of therapeutic efficacy. In this context, the study of trabecular microarchitecture has much to contribute. The emerging field of trabecular microarchitecture, however, is diverse, inter-disciplinary and encompasses many different imaging modalities. This volume represents a compilation of papers from world-renowned researchers, reflecting the most current research in the area of noninvasive assessment of trabecular microcarchitecture. This varied research applies sophisticated imaging tools to questions of bone biomechanics at both the basic science and clinical levels. The authors' works range from review articles and research articles to works in progress. Taken together, they offer a foray into the "state of the art" of investigating bone at its most basic levels.
The purpose of this research is to investigate the application of a Compton scatter imaging technique to measure bone density. A demonstration Multiplexed Compton Scatter Tomograph (MCST) was assembled to demonstrate the feasibility of detecting osteoporosis by modifying a system originally designed to detect hidden corrosion in aluminum aircraft wings. Measurements were performed on an aluminum phantom representing a wrist bone containing varying densities in the center and varying thickness of the cortical shell. The densities in the center are comparable to normal trabecular bone, sixty-percent of normal trabecular bone and a void. The MCST images of the phantom were then compared to simulated images from a detector. The images and simulations were also compared to images from a clinical computed tomography (CT) scanner. Based on the results, the MCST can discern the features represented by the trabecular bone. The system was able to differentiate normal, osteoporotic and void densities.
This book is the compilation of papers presented at the International Symposium on in vivo Body Composition Studies, held at the University of Toronto, Ontario, Canada, June 20 - 23, 1989. The purpose of this conference was to report on advances in techniques for the in vivo measurement of body composition and to present recent data on normal body composition and changes during disease. This conference was the most recent of several meetings on body composition studies, and follows two successful such meetings, one at Brookhaven National Laboratory in 1986, and at Edinburgh in 1988. The large number of excellent research papers and posters presented at these conferences demonstrates the rapid growth of the field and the broad interest in the subject of in vivo body composition studies. The proceedings of the Brookhaven meeting "In Vivo Body Composition Studies", is published by The Institute of Physical Sciences in Medicine, London. Both the Brookhaven and the current Toronto meeting emphasized the clinical applications, together with the techniques employed. The Edinburgh meeting placed more emphasis on the methodological problems and design of instrumentation. Because of the number of papers presented at the meeting it was necessary to ask the authors from the same institution to combine their presentations into a single paper where appropriate. The editors wish to thank the authors for their cooperation and for graciously accepting the minor revisions made to each manuscript.