What common issue can arise from the presence of hardware during a forearm DXA scan?

• A. It can cause a lower BMD result
• B. It can have no effect on BMD results
• C. It can lead to an increase in BMD results
• D. It can provide clearer images

Answer: (C)

The presence of hardware, such as plates, screws, or rods from previous surgeries, during a forearm DXA (dual-energy X-ray absorptiometry) scan can indeed complicate the assessment of bone mineral density (BMD). Typically, hardware can lead to an increase in BMD results. This occurs because the metal in the hardware absorbs more X-rays than the surrounding bone and tissue. As the DXA scan analyzes the absorption of X-rays to calculate BMD, the presence of this metallic hardware can artificially elevate the measurements, resulting in falsely high BMD values. This can ultimately mislead the clinician regarding a patient's actual bone health.

Understanding these effects is crucial for accurate interpretation of DXA results, particularly when evaluating patients who have undergone orthopedic procedures. Proper protocol often requires annotating the presence of such hardware in the patient’s medical record and possibly even excluding the affected area from the scan assessment to ensure more accurate representations of bone density.