When performing DEXA density assessment for spinal studies in lumbar spondylosis, what precaution should be taken?

• A. Use MRI for density.
• B. Density should be measured at the thoracic spine.
• C. Ensure no osteophytes are in the density assessment area.
• D. DEXA should be avoided in spinal studies.

Answer: (C)

In lumbar spine DEXA, degenerative changes like osteophytes can artificially raise the measured bone mineral density in the scanned area. The main precaution is to ensure the density assessment area excludes any osteophytes or other degenerative changes so the reading reflects true vertebral bone density rather than overlying bone growth. If osteophytes contaminate the ROI, the result can falsely appear normal or high, masking osteoporosis.

MRI isn’t used to measure bone density, so it doesn’t replace DEXA. Measuring density at the thoracic spine doesn’t solve the issue of lumbar osteophytes, and DEXA isn’t avoided altogether—alternative sites (like the hip or forearm) can be considered if the spine is confounded.