Bone Loss or a Case of Mistaken Identity

The diagnosis of osteoporosis and monitoring of treatment is a challenge due to the use of different technologies for measuring bone mineral density (BMD), with many instrument manufacturers, instrument models, and software versions. Interpreters of bone density tests must be aware of these complexities when evaluating the results, with care to examine the images as well as the numerical data. Dual-energy X-ray absorptiometry (DXA) is the "goldstandard" technology for the diagnosis of osteoporosis and monitoring the skeletal effects of treatment. However, BMD results can sometimes be misleading due to lack of technologist training leading to errors in patient positioning, incorrect analysis, or invalid data. This is a case presentation that illustrates an easily avoidable BMD testing error that could lead to inappropriate treatment decisions, highlighting the importance of quality BMD testing and reporting.