ARRT Bone Density Exam Test Bank 2023 with complete
solution
According to the WHO criteria, what is the diagnosis of osteoporosis based on the
measurement of bone density?
2.5 SD or more below the young adult peak bone density
What is the gold standard technique for measuring bone density?
DXA
Cancellous bone is also know as?
Trabecular Bone
What is the anatomical landmark on the proximal femur that gives the best visual
indication of the degree of rotation of the proximal femur?
Lesser Trochanter
Which lumbar vertebra is described as having a characteristic shape of an X or and H
on a DXA PA spine scan?
L4
Is Forteo a bisphosphonate?
NO
Quantitative Computated Tomography (QCT)
-measurements are volumetric
-trabecular bone can be isolated from cortical bone
-accuracy may be affected by marrow fat
Peripheral BMD measurements are advocated for _____________?
Screening
What is the most important clinical consequence of osteoporosis?
Fracture
What is the name of the tool that integrates clinical information in a quantitative manner
to predict a 10-year probability of major osteoporotic fracture for both men and women?
FRAX
What is the major source of precision error in clinical practice?
Technologist
What is the percentage of trabecular bone in the skeleton?
20 %
The forearm is not used to monitor the effects of therapy for osteoporosis because.......
rate of change in BMD is too slow
What site is mostly composed of cortical bone?
Proximal forearm
What are the advantages of QUS over x-ray methodologies for BMD measurement?
-ultrasound is comparatively inexpensive
-patients are not subjected to ionizing radiation
-ultrasound exams are quick to perform
,What is the name of the isotope that was used in SPA?
Iodine-125
What is the texture index that evaluates the pixel gray-level variations in lumber spine
DXA images?
TBS (Trabecular Bone Score)
When does type 2 primary osteoporosis generally occur?
after age 70
What technique used images of the hand and an aluminum wedge?
RA (Radiograhic Absorptiometry)
New bone is formed by the ___________?
osteoblasts
Cancellous bone is also known as _______________?
Trabecular bone
How would you start labeling the vertebral bodies on a PA lumbar scan?
Start at L4 and count/label up
With changes in rotation of the femoral neck, what happens?
Increases the BMD
If daily QC fails, what should be your first step of action?
-repeat the scan
-if scan fails again, then call for help
Although the technology is similar with all of the DXA units, the BMD results are
different because..........
-different calibration standards
-algorithms to calculate BMD
-differences in the ROI
-different databases
The primary mechanism of action of antiresorptive therapies is the direct interaction with
the __________________
osteoclasts
Which site is preferred for determination of fracture prediction?
proximal femur
What is one disease not associated with low BMD?
osteopetrosis
DXA results may be influenced by.........
-body thickness
-degenerative changes
-fractures
-scan mode
A great forearm scan should include.......
,-forearm centered
-forearm straight
-free of artifacts
Phantoms that mimic the shape and size of a skeletal region are called
______________________________.
anthromomorphic phantoms
What is the formula used to calculate BMD?
BMD = BMC/Area
How often should you perform the QA on the DXA unit?
everyday you scan
Radiogammetry is the measurement of bones using skeletal x-rays/radiographs. Which
site was often used?
metacarpals
With voltage switching units, what type of calibration is used?
continuous internal calibration--wheel or drum
For low energies, the most common process of absorption is the
________________________ effect.
photoelectric
What are some comparisons to the amount of effective dose given during a central DXA
scan?
-less than a day of background radiation
-less than a round trip from Boston to LA
-one-tenth of a chest xray
Why is the non-dominant arm used in bone densitometry?
reference values reflect non-dominant arm measurements
When measuring the proximal femur, how should the neck ROI be placed?
the neck ROI should be perpendicular to the femoral neck
What is the bone edge detection methodology?
it tests the machines ability to distinguish bone from soft tissue
What are the two most common methods for shifting the energies in DXA units?
-energy shifting
-k-edge filters
Why do you use the hip positioner during scanning of the proximal femur?
to place the femoral neck parallel to the tabletop
Bisphosphonates prevent bone loss by....
reducing the activity of the osteoclasts
If a patient has a history of hyperparathyroidism, what would the preferred site be for
evaluation?
33% or 1/3 of the forearm
What is important for serial monitoring?
precision
, What pharmaceutical may be suggested for a woman with a high risk of breast cancer
and elevated lipids?
Evista (Raloxifene)
What year was the Bone Mass Measurement Act proposed?
1997
What type of osteoporosis is a result of menopause?
Primary Osteoporosis Type 1
What classes of cells are involved in bone remodeling?
-osteoclasts
-osteoblasts
-osteocytes
What therapy mimics the effects of estrogen on bone and has antiestrogenic effects in
other tissue?
Raloxifene
In both men and women, bone mass increases until approximately what age?
30 years
What must be performed in order to compare studies when a new machine is bought?
cross-calibration
Which acronym best describes the least amount of BMD change that can be statistically
significant?
LSC
What are the 2 types of bone?
-cortical
-trabecular
What parameters are used to calculate rate of change for a follow-up scan?
BMD
The shoulders of a patient should be squared with their ________.
pelvis
What are the preferred sites for the measurement of bone density in children?
spine and total body less head
What percentage of the skeletal body mass is cortical bone?
80%
Bone mineral density is expressed as.........
g/cm squared
How many times should you scan a patient with in-vivo precision study?
-30 patients scanned twice
-15 patients scanned 3 times
When analyzing the PA spine, what should you not mess with?
Width of ROI box
How many places to the right of the decimal point is used in reporting BMD?
3
The name of the forearm sites are based on what?
solution
According to the WHO criteria, what is the diagnosis of osteoporosis based on the
measurement of bone density?
2.5 SD or more below the young adult peak bone density
What is the gold standard technique for measuring bone density?
DXA
Cancellous bone is also know as?
Trabecular Bone
What is the anatomical landmark on the proximal femur that gives the best visual
indication of the degree of rotation of the proximal femur?
Lesser Trochanter
Which lumbar vertebra is described as having a characteristic shape of an X or and H
on a DXA PA spine scan?
L4
Is Forteo a bisphosphonate?
NO
Quantitative Computated Tomography (QCT)
-measurements are volumetric
-trabecular bone can be isolated from cortical bone
-accuracy may be affected by marrow fat
Peripheral BMD measurements are advocated for _____________?
Screening
What is the most important clinical consequence of osteoporosis?
Fracture
What is the name of the tool that integrates clinical information in a quantitative manner
to predict a 10-year probability of major osteoporotic fracture for both men and women?
FRAX
What is the major source of precision error in clinical practice?
Technologist
What is the percentage of trabecular bone in the skeleton?
20 %
The forearm is not used to monitor the effects of therapy for osteoporosis because.......
rate of change in BMD is too slow
What site is mostly composed of cortical bone?
Proximal forearm
What are the advantages of QUS over x-ray methodologies for BMD measurement?
-ultrasound is comparatively inexpensive
-patients are not subjected to ionizing radiation
-ultrasound exams are quick to perform
,What is the name of the isotope that was used in SPA?
Iodine-125
What is the texture index that evaluates the pixel gray-level variations in lumber spine
DXA images?
TBS (Trabecular Bone Score)
When does type 2 primary osteoporosis generally occur?
after age 70
What technique used images of the hand and an aluminum wedge?
RA (Radiograhic Absorptiometry)
New bone is formed by the ___________?
osteoblasts
Cancellous bone is also known as _______________?
Trabecular bone
How would you start labeling the vertebral bodies on a PA lumbar scan?
Start at L4 and count/label up
With changes in rotation of the femoral neck, what happens?
Increases the BMD
If daily QC fails, what should be your first step of action?
-repeat the scan
-if scan fails again, then call for help
Although the technology is similar with all of the DXA units, the BMD results are
different because..........
-different calibration standards
-algorithms to calculate BMD
-differences in the ROI
-different databases
The primary mechanism of action of antiresorptive therapies is the direct interaction with
the __________________
osteoclasts
Which site is preferred for determination of fracture prediction?
proximal femur
What is one disease not associated with low BMD?
osteopetrosis
DXA results may be influenced by.........
-body thickness
-degenerative changes
-fractures
-scan mode
A great forearm scan should include.......
,-forearm centered
-forearm straight
-free of artifacts
Phantoms that mimic the shape and size of a skeletal region are called
______________________________.
anthromomorphic phantoms
What is the formula used to calculate BMD?
BMD = BMC/Area
How often should you perform the QA on the DXA unit?
everyday you scan
Radiogammetry is the measurement of bones using skeletal x-rays/radiographs. Which
site was often used?
metacarpals
With voltage switching units, what type of calibration is used?
continuous internal calibration--wheel or drum
For low energies, the most common process of absorption is the
________________________ effect.
photoelectric
What are some comparisons to the amount of effective dose given during a central DXA
scan?
-less than a day of background radiation
-less than a round trip from Boston to LA
-one-tenth of a chest xray
Why is the non-dominant arm used in bone densitometry?
reference values reflect non-dominant arm measurements
When measuring the proximal femur, how should the neck ROI be placed?
the neck ROI should be perpendicular to the femoral neck
What is the bone edge detection methodology?
it tests the machines ability to distinguish bone from soft tissue
What are the two most common methods for shifting the energies in DXA units?
-energy shifting
-k-edge filters
Why do you use the hip positioner during scanning of the proximal femur?
to place the femoral neck parallel to the tabletop
Bisphosphonates prevent bone loss by....
reducing the activity of the osteoclasts
If a patient has a history of hyperparathyroidism, what would the preferred site be for
evaluation?
33% or 1/3 of the forearm
What is important for serial monitoring?
precision
, What pharmaceutical may be suggested for a woman with a high risk of breast cancer
and elevated lipids?
Evista (Raloxifene)
What year was the Bone Mass Measurement Act proposed?
1997
What type of osteoporosis is a result of menopause?
Primary Osteoporosis Type 1
What classes of cells are involved in bone remodeling?
-osteoclasts
-osteoblasts
-osteocytes
What therapy mimics the effects of estrogen on bone and has antiestrogenic effects in
other tissue?
Raloxifene
In both men and women, bone mass increases until approximately what age?
30 years
What must be performed in order to compare studies when a new machine is bought?
cross-calibration
Which acronym best describes the least amount of BMD change that can be statistically
significant?
LSC
What are the 2 types of bone?
-cortical
-trabecular
What parameters are used to calculate rate of change for a follow-up scan?
BMD
The shoulders of a patient should be squared with their ________.
pelvis
What are the preferred sites for the measurement of bone density in children?
spine and total body less head
What percentage of the skeletal body mass is cortical bone?
80%
Bone mineral density is expressed as.........
g/cm squared
How many times should you scan a patient with in-vivo precision study?
-30 patients scanned twice
-15 patients scanned 3 times
When analyzing the PA spine, what should you not mess with?
Width of ROI box
How many places to the right of the decimal point is used in reporting BMD?
3
The name of the forearm sites are based on what?
