Discordance in diagnosis of osteoporosis using spine and hip bone densitometry.

Diagnostic discordance for osteoporosis is the observation that the T-score of a patient varies between skeletal sites, falling into 2 different diagnostic categories identified by the World Health Organization classification system. Densitometrists and clinicians should expect that at least 4 of every 10 patients tested by dual-energy X-ray absorptiometry (DXA) to demonstrate T-score discordance between spine and total hip measurement sites. T-score discordance can occur for a variety of reasons related to physiologic and pathologic patient factors and the performance or analysis of DXA itself.

[A rare trauma-associated cause of central retinal vein occlusion in a young subject]. / Une cause rare d'occlusion de la veine centrale de la rétine chez le sujet jeune dans un contexte traumatique.

INTRODUCTION: Retinal vein occlusions are the second leading cause of retinal vascular disease, after diabetic retinopathy. In the case of young subjects, a thorough etiological investigation must be conducted in order to diagnose rare etiologies, such as this heterozygous mutation of the factor II gene associated with a central retinal vein occlusion (CRVO), occurring in a young subject within the context of trauma. OBSERVATION: The case deals with a 35-year-old soldier on a mission in a conflict zone. He was the victim of blast injury as a result of the explosion of an improvised explosive device (IED) or homemade bomb, and presented a sudden decline in visual acuity in his left eye associated with the clinical picture of a CRVO. Analysis showed a heterozygous factor II G20210A gene mutation. CONCLUSION: Retinal vein occlusions are always serious visual events. In the case of young subjects, a thorough etiological investigation must be conducted in search of rare abnormalities likely to lead to retinal vein occlusion.