Doctors often use a scan called DXA (dual-energy X-ray absorptiometry) to measure bone mineral density. However, DXA does not always correctly show the risk of fractures in people with systemic mastocytosis (SM), according to a recent review published in the journal Frontiers in Endocrinology.
Bone health is an important concern for people with SM because the condition can weaken bones and make them more likely to break. In SM, immune cells called mast cells grow and collect in different parts of the body, including bones. These cells can damage bone structure, leading to osteopenia (mild bone loss), osteoporosis (more severe bone loss) and fractures.
Sometimes, DXA results can be confusing. In some conditions, including mastocytosis, bones may appear to have high density on the scan, even when they are weak and at risk of fracture. Because of this, it is important to look beyond just DXA results when monitoring bone health.
Other tools can give more helpful information. For example, the trabecular bone score (TBS) looks at bone quality, not just density.
Another test, called high-resolution peripheral quantitative computed tomography (HR-pQCT), can show detailed images of bone structure and strength. These tools help doctors better understand how likely a bone is to break.
Read more about SM signs and symptoms
Preventing fractures is very important, the researchers said. It is better to find and treat bone problems early rather than waiting for a fracture to happen.
DXA can be a helpful first test to give doctors a general idea of how strong the bones are and the risk of fracture. However, for people who have a higher risk of fractures — such as those with SM — more sensitive tests such as HR-pQCT help doctors better understand fracture risk and make more informed decisions about care and treatment.
“Applying a sensitive tool to predict fragility fracture is the cornerstone of screening patients with a history of underlying conditions that cause bone loss,” the researchers said.
Sign up here to get the latest news, perspectives, and information about SM sent directly to your inbox. Registration is free and only takes a minute.
