Bone-mineral density: clinical significance, methods of quantification and forensic applications

Figures & data

Table 1 Advantages and disadvantages of modalities used for assessment of bone mineral density

Method	Site	Rate	Advantages	Disadvantages	*RRL
X-ray	Thoracic or lumbar spine	5	Screening for bone fracture	Low sensitivity for bone loss	1–10 mSv
SXA	Heel	3	Low cost	Less predictive than DXA	<0.1 mSv
DXA	Spine	9			<0.1 mSv
DXA	Proximal femur	9			<0.1 mSv
DXA	Forearm	3	Suitable for patients with hyperthyroidism	Reduced accuracy compared to other sites	<0.1 mSv
QCT	Spine	8	More sensitive than DXA for individuals with high body mass index (>35 kg/m^2) and patients with degenerative joint disease	Higher dose of radiation than SXA/DXA	0.1––1 mSv
QCT	Proximal femur	3	More sensitive than DXA	Higher dose of radiation than SXA/DXA	0.1–1 mSv
pQCT	Forearm	2	More sensitive than DXA	Higher dose of radiation than SXA/DXA	<0.1 mSv
MRI	Pelvis, spine, low extremities		Low radiation exposure, soft tissue visualization	Standardization of image quality and quantification	0 mSv
QUS	Heel	5	Low cost	Not classified by WHO	0 mSv