Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method

Abstract Context Data regarding high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with adrenal incidentaloma (AI) are unknown. Purpose To evaluate the areal bone mineral density (aBMD), microstructure, and fractures in patients with nonfunctioning AI (NFAI) and autonomous cortisol secretion (ACS). Methods We evaluated 45 patients with NFAI (1 mg dexamethasone suppression test [DST] ≤1.8 µg/dL) and 30 patients with ACS (1 mg DST 1.9-5.0 µg/dL). aBMD was measured using dual-energy X-ray absorptiometry; vertebral fracture by spine X-ray; and bone geometry, volumetric bone mineral density (vBMD), and microstructure by HR-pQCT. Results Patients with ACS showed lower aBMD values at the spine, femoral neck, and radius 33% than those with NFAI. Osteoporosis was frequent in both groups: NFAI (64.9%) and ACS (75%). Parameters at the distal radius by HR-pQCT were decreased in patients with ACS compared to those with NFAI: trabecular vBMD (Tb.vBMD, P = 0.03), inner zone of the trabecular region (Inn.Tb.vBMD, P = 0.01), the bone volume/tissue volume ratio (BV/TV, P = 0.03) and trabecular thickness (P = 0.04). As consequence, a higher ratio of the outer zone of the trabecular region/inner zone vBMD (Meta/Inn.vBMD, P = 0.003) was observed. A correlation between the cortisol levels after 1 mg DST and Meta/Inn.vBMD ratio was found (r = 0.29; P = 0.01). The fracture frequency was 73.7% in patients with ACS vs 55.6% in patients with NFAI (P = 0.24). Conclusion Our findings point to an association between trabecular bone microarchitectural derangement at the distal radius and ACS. Our data suggest that AI have a negative impact on bone when assessed by HR-pQCT, probably associated to subclinical hypercortisolism.

Download Full-text

Assessment of the healing process in distal radius fractures by high resolution peripheral quantitative computed tomography

Bone ◽

10.1016/j.bone.2014.03.043 ◽

2014 ◽

Vol 64 ◽

pp. 65-74 ◽

Cited By ~ 31

Author(s):

Joost J.A. de Jong ◽

Paul C. Willems ◽

Jacobus J. Arts ◽

Sandrine G.P. Bours ◽

Peter R.G. Brink ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Distal Radius ◽

Healing Process ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Distal Radius Fractures ◽

Radius Fractures

Download Full-text

Sex- and Age-Related Differences in Bone Microarchitecture in Men Relative to Women Assessed by High-Resolution Peripheral Quantitative Computed Tomography

Journal of Osteoporosis ◽

10.1155/2012/129760 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Shreyasee Amin ◽

Sundeep Khosla

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Bone Strength ◽

Bone Biopsy ◽

Bone Microarchitecture ◽

Quantitative Computed Tomography ◽

Older Men ◽

Peripheral Quantitative Computed Tomography ◽

Men And Women ◽

Age Related

The trabecular and cortical compartments of bone each contributes to bone strength. Until recently, assessment of trabecular and cortical microstructure has required a bone biopsy. Now, trabecular and cortical microstructure of peripheral bone sites can be determined noninvasively using high-resolution peripheral quantitative computed tomography (HR-pQCT). Studies that have used HR-pQCT to evaluate cohorts of both men and women have provided novel insights into the changes in bone microarchitecture that occur with age between the sexes, which may help to explain the lower fracture incidence in older men relative to women. This review will highlight observations from these studies on both the sex- and age-related differences in trabecular and cortical microstructure that may underlie the differences in bone strength, and thereby fracture risk, between men and women.

Download Full-text