The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine

Abstract

Background: Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis.

Methods: A cohort of 500 patients (mean age: 63.9 ± 11.2 years) diagnosed with osteoarthritis and having a medical prescription for dual-energy X-ray absorptiometry (DXA) were recruited for the study. All patients underwent BMD measurements at lumbar spine and femoral sites by both DXA and REMS techniques.

Results: The T-score values for BMD at the lumbar spine (BMD-LS) by DXA were significantly higher with respect to BMD-LS by REMS across all OA severity scores, and the differences were more pronounced in patients with a higher degree of OA severity (p < 0.001). Furthermore, the percentage of subjects classified as "osteoporotic", on the basis of BMD by REMS was markedly higher than those classified by DXA, both when considering all skeletal sites (39.4% vs. 15.1%, respectively) and the lumbar spine alone (30.5% vs. 6.0%, respectively). A similar pattern was observed when OA patients were grouped according to the Kellgren-Lawrence grading score.

Conclusions: The findings from our study indicate that, in a population with varying severity levels of osteoarthritis, REMS demonstrated a higher capability to diagnose osteoporosis compared to DXA, and this could lead to earlier intervention and improved outcomes for patients with bone fragility, reducing the likelihood of fractures and associated complications.

Keywords: Kellgren/Lawrence grading score; bone mineral density (BMD); dual-energy X-ray absorptiometry (DXA); osteoarthritis; osteoporosis; radiofrequency echographic multispectrometry (REMS).

Figure 1

Flow chart showing the distribution of participants to the DEMETER Study.

Figure 2

BMI-adjusted partial correlation between BMD-LS T-score by DXA technique and BMD-LS T-score by REMS technique according to osteoarthritis score (K-L score 0/1 = (A), K-L score 2 = (B), K-L score 3 = (C), and K-L score 4 = (D)).

Figure 3

Values of BMD expressed as a T-score at the lumbar spine by DXA and REMS techniques grouped by OA score.

Figure 4

The proportion of osteoarthritis (OA) patients categorized as “osteoporotic”, “osteopenic”, or “normal” based on BMD T-score values acquired through DXA and REMS techniques specifically at the lumbar spine (A) or across all skeletal sites (B).

Figure 5

Percentage of patients classified as “osteoporotic”, “osteopenic”, or “normal” at the lumbar spine alone (A) or at all skeletal sites (B) according to the K-L score.