The influence of aging on the association between adiposity and bone mineral density in Jordanian postmenopausal women.

The objective of this study was to assess the relative association between body weight, body mass index (BMI), lean mass (LM) and fat mass (FM), and bone mineral density (BMD) in a group of Jordanian postmenopausal women and investigate if this possible association changes with age. A total of 3256 patients had dual-energy X-ray absorptiometry (DXA) scan in the period from January 2009 till January 2012 at the Radiology and Nuclear Medicine Department of Jordan University Hospital. Only 584 women met the selection criteria. Age has been recorded, and patients were divided into subgroups according to age. Body weight and height were measured, and BMI was calculated. Body composition (LM, FM, percentage of android fat, and percentage of gynoid fat) was assessed by DXA. BMD of the lumbar spine (L1-L4) and femoral neck was measured by DXA. Weight, BMI, FM, LM, percentage of android fat, and percentage of gynoid fat were positively correlated to BMD at both lumbar spine and femoral neck. However, this correlation disappeared at the age of 70 yr at lumbar spine and 75 yr at femoral neck. This study suggests that both FM and LM are important determinants of BMD in Jordanian postmenopausal women, and this correlation disappears after the age of 70 yr at lumbar spine and 75 yr at femoral neck.

Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?

BACKGROUND: Complex regional pain syndrome (CRPS) is characterized by pain in combination with sensory, vasomotor, sudomotor, trophic and motor abnormalities. The diagnosis of CRPS is based primarily on clinical criteria and the presence of distinct signs and symptoms. The role of bone scintigraphy in the diagnosis of these patients has been limited by its variable sensitivity. In this study, we aim to look if the presence of specific symptoms or symptom subgroups in patients with clinically diagnosed CRPS correlates with scintigraphic findings in bone scan. MATERIALS AND METHODS: We retrospectively reviewed clinical records of patients referred for bone scintigraphy with the clinical diagnosis of CRPS during the period December 2006 until February 2011. Patients were classified into 4 distinct subgroups according to the presence of specific symptoms namely sensory subgroup, sudomotor and/or edema subgroup, vasomotor subgroup and finally motor and/or trophic changes subgroup. We looked specifically for the correlation between these specific symptoms and scintigraphic bone findings. RESULTS: 37 patients were referred for bone scintigraphy with the clinical diagnosis of CRPS and were enrolled in the study. The presence of vasomotor symptoms and (motor and/or trophic changes) was significantly higher in patients with positive bone scintigraphy (P value 0.0133, 0.018 respectively). There was no other statistically significant correlation between the presence of specific symptoms or symptom subgroups on one hand and the result of bone scintigraphy on the other hand. CONCLUSIONS: The probability of positive bone scintigraphy increased significantly in patients with vasomotor symptoms and in patients with motor and/or trophic changes. This may contribute to the reported variability of the diagnostic performance of bone scintigraphy in CRPS patients.

The role of B-mode ultrasonography in the detection of urolithiasis in patients with acute renal colic.

This study was conducted to assess the diagnostic yield of B-Mode Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who underwent unenhanced urinary tract CT scan and ultrasonography for suspicion of urolithiasis. Both techniques were used to determine the presence or absence, site, size, and number of urinary stones, as well as presence of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were measured considering unenhanced CT scan as a gold standard. Unpaired two-tailed student's t-test was used for comparison between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 +/- 3.3 mm, 6 +/- 1.8 mm and 4.18 +/- 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and accuracy of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is inconclusive.