A new X-ray based osteoporosis screening tool provides accurate and precise assessment of phalanx bone mineral content

Many devices currently available for the assessment of osteoporosis require a significant capital investment, are not portable, and require specially trained operators. The objective of this study was to assess the accuracy and precision of a new tabletop dual-energy computed digital absorptiometry (CDA) device (accuDEXA(TM), Schick Technologies, Long Island City, NY) designed to automatically and instantaneously assess bone mineral content (BMC) and bone mineral density (BMD) of the middle finger. BMC and BMD of 26 cadaveric forearms were measured by dual-energy X-ray absorptiometry, radiographic absorptiometry (RA), and CDA. accuDEXA measurements were repeated five times with and without repositioning on 10 forearms, The portion of the finger evaluated by accuDEXA was then excised, measurements of the specimen were again obtained using the accuDEXA device, and the specimen was incinerated to determine ash weight. BMC assessed by accuDEXA and by RA were strongly correlated with ash weight of the excised phalanx specimens (r(2) = 0.94 and r(2) = 0.96, respectively). Short-term precision for BMD assessed by the accuDEXA device was 0.9% without repositioning, and 1.8% with repositioning. BMD determined by the accuDEXA device was strongly correlated with BMD of the hand and forearm (r(2)=0.56-0.69). Dual-energy CDA is a new bone densitometry technique that provides rapid, precise, and accurate measurements of the middle phalanx of the third finger. The technique may be useful for widespread testing of osteoporotic patients.