Bone Densitometry Course

Lesson 1 • Bone Growth and Peak Bone Mass

Describes longitudinal bone growth, epiphyseal plate closure, and attainment of peak bone mass. Establishes reference points used in T-score and Z-score calculations.

Lesson 2 • Bone Composition and Microstructure

Covers cortical and trabecular bone architecture, mineral matrix, and cellular components. Provides the anatomical baseline needed for understanding density measurement.

Lesson 3 • Calcium and Phosphorus Homeostasis

Explains hormonal regulation of calcium and phosphorus balance and its direct effect on bone density. Links metabolic pathways to measurable densitometric outcomes.

Lesson 1 • X-Ray Production and Beam Properties

Covers X-ray tube function, photon energy spectra, and beam collimation relevant to densitometry. Grounds students in the physics before introducing dual-energy methods.

Lesson 2 • Dual-Energy X-Ray Absorptiometry Principles

Details how two photon energies separate bone mineral from soft tissue to yield BMD. Connects attenuation physics directly to DXA measurement algorithms.

Lesson 3 • Photon Attenuation Principles

Explains photoelectric absorption, Compton scatter, and mass attenuation coefficients in tissue. These principles underpin the separation of bone from soft tissue in DXA.

Lesson 1 • Equipment Maintenance and Troubleshooting

Addresses routine maintenance schedules, artefact recognition, and systematic troubleshooting steps. Minimises scan downtime and protects data integrity.

Lesson 2 • Precision Assessment and LSC Calculation

Teaches short-term precision studies, coefficient of variation calculation, and least significant change. Students determine whether interval BMD changes are clinically meaningful.

Lesson 3 • Cross-Calibration Between Scanners

Explains phantom-based and in-vivo cross-calibration methods when patients transfer between systems. Prevents misclassification of bone loss due to equipment differences.

Lesson 4 • Daily Quality Control Procedures

Covers phantom scanning protocols, acceptance criteria, and corrective actions for QC failures. Consistent QC ensures longitudinal data reliability across patient visits.

Lesson 1 • Lumbar Spine Positioning Technique

Details supine positioning, leg elevation, and ROI landmark identification for L1–L4 acquisition. Accurate spine positioning is the most critical factor in lumbar BMD reproducibility.

Lesson 2 • Proximal Femur Positioning Technique

Covers internal rotation, foot positioning device use, and femoral neck axis alignment. Consistent femur positioning is essential for neck and total hip BMD accuracy.

Lesson 3 • Pediatric and Special Population Positioning

Adapts positioning protocols for children, bariatric patients, and those with physical limitations. Ensures valid data collection across diverse patient populations.

Lesson 4 • Patient Screening and Contraindications

Reviews intake questionnaires, recent contrast or nuclear medicine exposure, and pregnancy screening. Proper screening prevents invalid scans and protects patient safety.

Lesson 1 • Artefact Recognition and Scan Exclusion

Identifies motion artefacts, metallic implants, calcifications, and degenerative changes that invalidate ROIs. Students apply exclusion criteria to protect diagnostic accuracy.

Lesson 2 • Proximal Femur Analysis and ROI Placement

Details femoral neck box placement, trochanter and Ward's area boundaries, and total hip ROI. Accurate femur analysis is critical for fracture risk assessment and monitoring.

Lesson 3 • Forearm and Whole-Body Analysis

Covers one-third radius ROI placement, ultradistal region identification, and whole-body composition regions. Expands analytical skills to non-central skeletal sites.

Lesson 4 • Lumbar Spine Analysis and ROI Placement

Teaches intervertebral line placement, vertebral body inclusion criteria, and edge detection review. Correct analysis directly determines the reported L1–L4 BMD and T-score.

Lesson 1 • WHO Diagnostic Classification System

Applies the WHO T-score thresholds for normal, low bone mass, osteoporosis, and severe osteoporosis. Establishes the standard classification framework used in clinical reporting.

Lesson 2 • Vertebral Fracture Assessment Interpretation

Covers Genant semi-quantitative grading of vertebral deformities identified on lateral DXA images. Adds fracture identification to the densitometric diagnostic report.

Lesson 3 • Interpreting Results in Special Populations

Adapts interpretation for premenopausal women, men, children, and secondary osteoporosis cases. Z-score use and population-specific databases prevent misdiagnosis.

Lesson 4 • Reference Databases and Score Derivation

Explains how normative reference databases are constructed and how T-scores and Z-scores are derived. Correct database selection is foundational to valid diagnostic classification.

Lesson 1 • FRAX Tool Application

Demonstrates FRAX input variables, output interpretation, and intervention threshold application. Integrates BMD with clinical risk factors for 10-year fracture probability.

Lesson 2 • Fracture Risk Factors Beyond BMD

Identifies independent clinical risk factors that contribute to fracture probability beyond BMD alone. Establishes the rationale for multi-variable fracture risk tools.

Lesson 3 • Reporting and Clinical Communication

Structures a complete densitometry report including BMD, T-scores, FRAX, and clinical recommendations. Clear reporting bridges technical findings and referring clinician decision-making.

Lesson 4 • Trabecular Bone Score Integration

Explains TBS as a texture-based index of bone microarchitecture derived from lumbar DXA images. TBS adjusts fracture risk estimates when BMD alone underestimates risk.

Lesson 1 • Hip Structural Analysis

Applies geometric analysis of femoral neck cross-sections to estimate bone strength indices. Provides biomechanical data supplementing standard BMD for fracture risk.

Lesson 2 • Body Composition Analysis with DXA

Covers lean mass, fat mass, and visceral adipose tissue quantification using whole-body DXA. Expands clinical utility of DXA beyond skeletal assessment.

Lesson 3 • Quantitative Computed Tomography

Introduces QCT as a volumetric BMD technique separating cortical and trabecular compartments. Contrasts QCT advantages and limitations with DXA for specific clinical scenarios.

Lesson 4 • Quantitative Ultrasound of Bone

Describes calcaneal QUS parameters, their relationship to bone quality, and role as a screening tool. Positions QUS within the broader bone assessment technology landscape.