Title: May 2015 – To Delete Or Not To Delete, That Is The Question

Submitted by Larry Jankowski, CBDT

In this months case, we explore a practical solution to a theoretical question which is also one of the most common issues for technologists performing a DXA scan at the spine: Whether or not discordance in T-scores warrant their exclusion from analysis. The idea came from a member who posted a seemingly simple question on the Ask the Expert feature of the ISCD website, that went like this:

“Lumbar spine T-score:
L1- -0.2
L2 -0.4
L3 -2.3
L4 -1.2
Which of these vertebrae should I exclude and why? Thank you.”

My reply as the assigned expert, was not as simple, necessitated by the fact that the Ask the Expert system cannot accept images (HIPAA privacy laws being what they are here in the U.S.). So, here is a different example from which to launch our discussion that has an image and supporting tables of data..



  • In this case, using the spine scan and associated T-scores shown here, how would you answer the same question: Which vertebra(e) would you delete and why?

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