Vascular Calcification

Case Description:

This DXA scan shows aortic calcification, with the accompanying postero-anterior and lateral radiographs showing the aortic calcification. The red lines are point to the aortic calcification. Aortic calcification will tend to overestimate bone mineral density. Aortic calcification is easily appreciated on vertebral fracture assessment (VFA) images. The effect of aortic calcification on bone mineral density has been found to be variable in the literature, however, any authors have found that the additional calcium can increase lumbar spine BMD.

Credit:

Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham

References:

• Orwoll, E.S., S.K. Oviatt, and T. Mann, The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. J Clin Endocrinol Metab, 1990. 70(4): p. 1202-7
• Reid, I.R., et al., The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women. J Clin Endocrinol Metab, 1991. 72(6): p. 1372-4.
• Gupta, S.K., Potential Impact of Abdominal Aortic Calcification Identification on Bone Density Lateral Spine Images in Clinical Practice. J Clin Densitom, 2016. 19(4): p. 411-412.
• Lewis, J.R., et al., Abdominal Aortic Calcification Identified on Lateral Spine Images From Bone Densitometers Are a Marker of Generalized Atherosclerosis in Elderly Women. Arterioscler Thromb Vasc Biol, 2016. 36(1): p. 166-73.
• Schousboe, J.T., S.A. Richter, and M.S. Beran, Potential Clinical Impact of Abdominal Aortic Calcification on Bone Density Lateral Spine Images. J Clin Densitom, 2016. 19(4): p. 436-443.
• Cherney, D.D., et al., A study on the influence of calcified intervertebral disk and aorta in determining bone mineral density. J Clin Densitom, 2002. 5(2): p. 193-8.
• Frye, M.A., et al., Osteoporosis and calcification of the aorta. Bone Miner, 1992. 19(2): p. 185-94.
• Smith, J.A., et al., Aortic calcification contributing to bone densitometry measurement. J Clin Densitom, 1999. 2(2): p. 181-3.
• Drinka, P.J., S.F. Bauwens, and A.A. DeSmet, Lack of correlation between aortic calcification and bone density. Wis Med J, 1992. 91(6): p. 299-301.
• Drinka, P.J., et al., The effect of overlying calcification on lumbar bone densitometry. Calcif Tissue Int, 1992. 50(6): p. 507-10.
• Bristow, S.M., et al., Longitudinal changes in bone mineral density, bone mineral content and bone area at the lumbar spine and hip in postmenopausal women, and the influence of abdominal aortic calcification. Bone Rep, 2019. 10: p. 100190.