Dual Energy X-Ray Absorptiometry of the Distal Femur May Be More Reliable than the Proximal Tibia in Spinal Cord Injury

Leslie R. Morse, Antonio A. Lazzari, Ricardo Battaglino, Kelly L. Stolzmann, Kirby R. Matthess, David R. Gagnon, Samuel A. Davis, Eric Garshick

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Morse LR, Lazzari AA, Battaglino R, Stolzmann KL, Matthess KR, Gagnon DR, Davis SA, Garshick E. Dual energy x-ray absorptiometry of the distal femur may be more reliable than the proximal tibia in spinal cord injury. Objective: To evaluate the precision of dual energy x-ray absorptiometry scanning at 2 skeletal sites at the knee (proximal femur and distal tibia) in people with SCI. Design: Cross-sectional. Setting: Veterans Affairs Medical Center. Participants: Subjects (N=20) with chronic SCI. Interventions: Not applicable. Main Outcome Measures: Precision as determined by root mean square coefficient of variation (RMS-CV) and root mean square standard deviation (RMS-SD). Results: At the distal femur the root RMS-CV was 3.01% and the RMS-SD was 0.025g/cm2. At the proximal tibia the RMS-CV was 5.91% and the RMS-SD was 0.030g/cm2. Conclusions: Precision at the distal femur is greater than at the proximal tibia and we recommend it as the preferred site for the longitudinal assessment of bone mineral density at the knee in chronic SCI.

Original languageEnglish (US)
Pages (from-to)827-831
Number of pages5
JournalArchives of Physical Medicine and Rehabilitation
Issue number5
StatePublished - Apr 28 2009
Externally publishedYes

Bibliographical note

Funding Information:
Supported by the Office of Research and Development, Health Services R&D Service, Quality Enhancement Research Initiative (grant no. RRP-07-312); National Institutes of Health (grant nos. K12 HD001097-08, RO1HD42141, and R21HD057030). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Copyright 2009 Elsevier B.V., All rights reserved.


  • Bone mineral density
  • Osteoporosis
  • Precision
  • Rehabilitation
  • Spinal cord injuries


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