Inter-relation of Hypocalcemia with Established Osteoporosis and DXA Analysis – A Prospective Study of 100 Indian Subjects
Volume 1 | Issue 1 | October 2020-March 2021 | page: 19-22 | Bharat R. Dave, Himanshu Kulkarni, Devanand Degulmadi, Shivanand Mayi, Ravi Ranjan Rai, Kirit Jadav, Ajay Krishnan
Authors: Bharat R. Dave , Himanshu Kulkarni , Devanand Degulmadi , Shivanand Mayi , Ravi Ranjan Rai , Kirit Jadav , Ajay Krishnan 
 Stavya Spine Hospital and Research Institute, Near Nagari Eye Hospital, Mithakhali, Ellisbrige, Ahmedabad, Gujarat, India .
Address of Correspondence
Dr. Ajay Krishnan,
Stavya Spine Hospital and Research Institute, Ahmedabad, Gujarat, India .
Purpose: The purpose of the study was to screen the presence of hypocalcemia and clinical signs specific to hypocalcemia in dual-emission X-ray absorptiometry proven osteoporotic patients and also to analyze variations of T scores at specific anatomical regions in lumbar spine and hip.
Type: Prospective cohort.
Materials and Methods: One hundred patients who had T score of <−2.5 at any of the lumbar levels or in total lumbar T score were selected. Ionic calcium levels (normal – 1.1–1.135 mmol/L) of each patient were calculated. Trousseau’s sign and Chvostek’s sign were checked. Analysis of T scores was done for each patient.
Results: Twelve out of 100 patients had hypocalcemia. Out of whom, only one patient had positive Trousseau’s sign and none had Chvostek’s sign present. In normocalcemic patients (n = 88), seven patients had positive Trousseau’s sign and three had Chvostek’s sign present. Average total lumbar T score of 100 patients was −3.0 (±1.1 SD). After calculating the averages, the L3 had least T score of −3.3 (±0.9 SD) and L1 had highest T score of −2.5 (±1.3 SD), respectively. Twenty-seven patients had total hip T scores <−2.5 and 72 patients had T scores <−2.5 at Ward’s triangle. Similarly, average total hip T score of 100 patients was −2.0 (±1.6 SD); average T score at Ward’s angle was much lower at −2.9 (±1.4SD).
Conclusion: L3 vertebra and Ward’s triangle are most sensitive indicators of osteoporosis. Although theoretically unlikely, hypocalcemia can be present in osteoporotic patients. Trousseau’s sign and Chvostek’s sign may be present in patients with established hypocalcemia; however, their absence does not rule out the diagnosis.
Keywords: Osteoporosis, hypocalcemia, T score, ward’s triangle.
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|How to Cite this Article: Dave BR, Kulkarni H, Degulmadi D, Mayi S, Rai RR, Jadav K, Krishnan A| Inter-relation of Hypocalcemia with Established Osteoporosis and DXA Analysis – A Prospective Study of 100 Indian Subjects | Back Bone: The Spine Journal | October 2020-March 2021; 1(1): 19-22.|
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