high prevalence of discordance in osteoporosis diagnosis between spine and hip bone densitometry in rafsanjan

Background: assessing bone mineral density (bmd) at a minimum of two skeletal sites is crucial for diagnosing osteoporosis. this research aimed to examine the discordance in bmd measurements between the lumbar spine and proximal femur using dual-energy x-ray absorptiometry (dxa), along with several influencing factors.methods: this cross-sectional analysis included 1270 patients from the rafsanjan bmd center in 2021. eligible participants were at least 20 years old and possessed one or more risk factors for osteoporosis. bone mineral density was assessed in the femoral region and the l1-l4 lumbar vertebrae using the dxa technique. based on the t-score, values below -2.5 were classified as osteoporosis, while scores between -1 and -2.5 indicated osteopenia. the data were analyzed using spss 22 software, with a significance threshold of p < 0.05 for statistical analyses.results: females constituted 83.5% of the study population, with 46.9% of all participants aged between 50 and 65 years. t-score analysis revealed 48.6% (617 cases) concordance, 44.5% (565 cases) minor discordance, and 6.9% (88 cases) major discordance. according to the z-score, the results showed 60% (762 cases) concordance, 37.5% (476 cases) minor discordance, and 2.5% (32 cases) major discordance.conclusion: the proportional odds model indicated that gender, age, tea consumption, residence location, and physical activity level were significant predictors affecting the likelihood of bmd discordance. consequently, clinicians should anticipate discrepant t-score and z-score results between the spine and hip in approximately 50% of patients.