Which One Can Detect More Osteopenia and Osteoporosis in Rheumatoid Arthritis Patient? Dual-Energy X-Ray Absorptiometry (Dxa) or Trabecular Bone Score (Tbs) Publisher



Monjezi D ; Shojaie B ; Salesi M
Source: International Journal of Preventive Medicine Published:2026

Abstract

Background: The early diagnosis of osteopenia and osteoporosis can slow the progression of osteoporosis and postpone possible bone fractures in patients with rheumatoid arthritis (RA) because of the benefit of timely treatments. This study was conducted to evaluate the efficiency of dual-energy X-ray absorptiometry (DXA) and trabecular bone score (TBS) in patients with RA to introduce a better method for the early diagnosis of osteopenia and osteoporosis. Methods: Data on DXA and TBS from 88 patients with RA and 52 healthy people who met the inclusion criteria of this retrospective study were analyzed based on descriptive and inferential statistics. Results: A significant difference was observed between the diagnostic abilities of TBS and DXA. Unlike the TBS method, DXA detected higher percentages of RA patients with osteopenia (31.82% TBS vs. 51.14% DXA) and osteoporosis (21.59% TBS vs. 26.14% DXA). Gender might also affect the diagnostic ability of DXA and TBS in patients with RA. In a group of RA patients, TBS diagnosed a lower percentage of patients with osteopenia and osteoporosis (26.83% TBS vs. 68.29% DXA for osteopenia and 17.07% TBS vs. 26.82% DXA for osteoporosis). These results may indicate a lower accuracy of the TBS method for diagnosing bone mass than DXA. Conclusions: Although previous studies have demonstrated that TBS is a proper method for the evaluation of bone microstructure, our study suggests that the results of the DXA should not be ignored for the early detection of osteopenia and osteoporosis in patients with RA. © 2026 International Journal of Preventive Medicine.