A 56-year-old man with prostate adenocarcinoma, who has undergone a prostatectomy, androgen deprivation therapy, and chemotherapy including prednisone presents for an initial DXA referral. A DXA scan (Fig. A) shows total lumbar BMD of 0.815 g/cm2 and a T-score of –2.5. Individual lumbar T-scores were: L1 = –3.3, L2 = 1.6, L3 = –4.2, and L4 = –3.6. An artifact overlays L2 and the adjacent soft tissue. The patient discloses he had computed tomography (CT) imaging earlier the same day with oral and intravenous (IV) iodine-based contrast.
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The International Society for Clinical Densitometry. Official Positions – Adult. 2015 ISCD. Available at: www.iscd.org. Accessed March 1, 2019.
Morgan SL, Lopez-Ben R, Nunnally N, et al. The effect of common artifacts lateral to the spine on bone mineral density in the lumbar spine. J Clin Densitom. 2008;11:243-249.
Spiro A, Hoang TD, Shakir MKM. Artifacts Affecting Dual-energy X-ray Absorptiometry Measurements. AACE Clinical Case Rep. Aug 2019;5(4):e263-266.