GuideNet: Learning Inter- Vertebral Guides in DXA Lateral Spine Images

Background: Osteoporosis presents a major threat to the health of women older than 65 years. Bisphosphonates (BPs) are now the principal class of medications for osteoporosis. Objective: To evaluate the efficacy and safety of BPs in women older than 65 years. Methods: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was undertaken for randomized controlled trials (RCTs) on the efficacy and safety of BPs in women older than 65 years. The primary outcome measures were the change in bone mass density (BMD), serum bone turnover marker levels, fracture rate and the adverse effect (AE) rate. The final search was performed in August 2019. Results: Seven RCTs were included. A total of 23287 patients met the inclusion criteria. BPs significantly increased the BMD of the posteroanterior (PA) spine, lateral spine and femoral neck, and reduced the fracture, vertebrate fracture and hip fracture rates in women older than 65 years. In addition, BPs increased the risks for pyrexia, myalgia, arthralgia, headache and influenza-like symptoms and had no statistical effect on any AEs, any serious AEs, discontinuation due to AEs, oesophagitis, any upper gastrointestinal adverse event, atrial fibrillation and myocardial infarction occurrence in women older than 65 years. Finally, intravenous BPs reduced hip fracture risk but increased AEs in women older than 65 years. Conclusion: Despite the fact that AEs significantly increased after drug delivery, BPs are highly effective and safe for managing osteoporosis in women older than 65 years. Zoledronic acid caused an increased rate of AEs in women older than 65 years, but these AEs seemed to be mild to moderate. In addition, the hip fracture rate in women older than 80 years old treated with BPs was different than that in the other included patients. Therefore, doctors may prescribe BPs for women older than 65 years in order to increase BMD, and AEs and hip fractures in women older than 80 years should be given attention.

Download Full-text

POS1018 IMPORTANCE OF LATERAL SPINE VIEW IN DXA BONE DENSITOMETRY IN PATIENTS WITH SPONDYLOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4294 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 776.3-777

Author(s):

S. Miri ◽

H. Ferjani ◽

K. Maatallah ◽

A. Kasraoui ◽

D. Kaffel ◽

...

Keyword(s):

Femoral Neck ◽

Structural Changes ◽

Age Of Onset ◽

Posterior Part ◽

Lateral View ◽

Mineral Density ◽

Lateral Spine ◽

Male Predominance ◽

T Score ◽

The Mean

Background:Osteoporosis is an increasingly important health problem among patients with spondyloarthritis (SPA). The Measure of Bone Mineral Density BMD is routinely carried out in an anteroposterior (AP) view of the spine. However, the syndesmophytes, ligaments calcifications, and the posterior part of vertebrae affect AP scanning. A lateral spine view is a more sensitive tool in assessing bone loss in trabecular bone.Objectives:We aimed to evaluate the association between lateral lumbar DXA and syndesmophyte grading in patients with SPA.Methods:We conducted a retrospective study including 75 patients with SPA. Bone density of the hip and lumbar spine was measured with a GE Lunar Prodigy Advance Bone Densitometer equipment. All patients had lumbar lateral, AP, and proximal femur DXA scans. The T-score, which measures the difference between a patient’s BMD and young-normal subjects, was computed and age-matched.Results:The mean age of the patients was 36±11 years. Male predominance was noted with a sex ratio of 4.76. The mean BMI was 25±5 kg/m2. Eight percent were obese. Fifty-two percent had Vitamin D deficiency.Forty-eight percent of the patients had axial SPA, while 52% had axial and peripheral symptoms.The mean age of onset was 27±7 years. Fifty-two percent of the patients had high inflammatory biomarkers. The BASDAI, ASDAS-VS, and ASDAS-CRP mean levels were respectively: 3.5±2.4, 3.1±0.9, and 3±0.8. The mean BASRI and mass were respectively 8 + 4.8 and 16.4 + 19.4. Analyses of T-score values obtained over the femoral neck revealed osteoporosis in 18.7% of the cases and osteopenia in 32% of the cases. On the other hand, analyses of AP, spine views revealed osteoporosis in 25.3% and osteopenia in 45.3% of patients (p=0.028, r=0.254). We detected the highest percentage of osteoporosis in lateral lumbar view and T-scores matched more closely with femoral neck values; osteoporosis in 29.3%, and osteopenia in 22.7% of the patients (p<10-3, r=0.562). BMD measured in AP, and lateral views were in good agreement (p<10-3, p=0.592). Age was inversely but not significantly associated with BMD in lateral (p=0.442, r=-0.09), AP (p=0.319, r=-0.117) and femoral neck projections (p=0.179, r=-0.157). Femoral neck BMD was associated with the activity of SPA (ASDAS vs (p=0.027, r= -0.295), and the mobility limitation BASMI (p=0.032, r= -0.247). Coxitis, BASRI, or mSASS were independent of BMD.Conclusion:We conclude that spine lateral view in DXA accurately measures BMD exceeding the AP spine views and femoral neck values. Therefore, structural changes do not affect this measurementDisclosure of Interests:None declared.

Download Full-text

Low Levels of Estradiol Are Associated with Vertebral Fractures in Older Men, But Not Women: The Rancho Bernardo Study1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.1.6327 ◽

2000 ◽

Vol 85 (1) ◽

pp. 219-223 ◽

Cited By ~ 1

Author(s):

Elizabeth Barrett-Connor ◽

Judith E. Mueller ◽

Denise G. von Mühlen ◽

Gail A. Laughlin ◽

Diane L. Schneider ◽

...

Keyword(s):

Vertebral Fractures ◽

Critical Role ◽

Dehydroepiandrosterone Sulfate ◽

Older Men ◽

Community Dwelling ◽

Total Testosterone ◽

Skeletal Health ◽

Lateral Spine ◽

Assay Sensitivity ◽

Endogenous Estrogen

This longitudinal study included 288 postmenopausal women without estrogen use (median age, 72 yr) and 352 men (median age, 66 yr). All were community-dwelling, ambulatory, and Caucasian. Blood for hormone assays (total and bioavailable estradiol and testosterone, estrone, androstenedione, dihydrotestosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate) was obtained in 1984–1987, and vertebral fractures were diagnosed from lateral spine radiographs obtained in 1992–1996. At least one vertebral fracture was found in 21% of women and 8% of men. Among men, age-adjusted hormone levels differed by fracture status only for total (64.1 vs. 75.4 pmol/L, P = 0.012) and bioavailable (43.0 vs. 51.4 pmol/L, P = 0.008) estradiol. There was a graded association between higher concentrations of total and bioavailable estradiol and lower fracture prevalence (trend P < 0.01 for both hormones). Men with total testosterone levels compatible with hypogonadism (<7 nmol/L) were not more likely to have vertebral fractures. In women, none of the measured sex hormones was associated with vertebral fractures. There was also no increased prevalence of fractures in women with estradiol levels below the assay sensitivity (<11 pmol/L). These data suggest that estrogen plays a critical role in the skeletal health of older men and confirm other studies showing no association of postmenopausal endogenous estrogen levels with vertebral fractures in older women.

Download Full-text

Description of the larva of Archilestes exoletus (Hagen in Selys) (Odonata: Lestidae)

Zootaxa ◽

10.11646/zootaxa.2756.1.5 ◽

2011 ◽

Vol 2756 (1) ◽

pp. 65 ◽

Cited By ~ 2

Author(s):

MARINA SCHMIDT DALZOCHIO ◽

MARCIEL ELIO RODRIGUES

Keyword(s):

Abdominal Segment ◽

Lateral Spine

The larva of Archilestes exoletus (Hagen in Selys, 1862) is described and illustrated based on exuviae of reared larvae collected in Cascavel, State of Paraná, Brazil. The larva of A. exoletus can be distinguished from other species of Archilestes of which the larva has been described by the absence of a lateral spine at the margin of the 4 th abdominal segment and having the cleft of the ligula closed.

Download Full-text

Fully Automatic Segmentation and Evaluation of Lateral Spine Radiographs

Informatik aktuell - Bildverarbeitung für die Medizin 2003 ◽

10.1007/978-3-642-18993-7_84 ◽

2003 ◽

pp. 413-417

Author(s):

Michael Kohnen ◽

Andreas H. Mahnken ◽

Alexander S. Brandt ◽

Rolf W. Günther ◽

Berthold B. Wein

Keyword(s):

Automatic Segmentation ◽

Lateral Spine ◽

Fully Automatic ◽

Spine Radiographs

Download Full-text

Direct (Extreme) Lateral Spine Surgery ☆

Reference Module in Neuroscience and Biobehavioral Psychology ◽

10.1016/b978-0-12-809324-5.04158-4 ◽

2017 ◽

Author(s):

Jay F. Dalton ◽

Jakub Godzik ◽

Alex Whiting ◽

Benjamin B. Whiting ◽

Mark A. Mahan ◽

...

Keyword(s):

Spine Surgery ◽

Lateral Spine

Download Full-text

Statin Use is Associated With Insulin Resistance in Participants of the Canadian Multicentre Osteoporosis Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa057 ◽

2020 ◽

Vol 4 (8) ◽

Cited By ~ 1

Author(s):

Karen J Rees-Milton ◽

Patrick Norman ◽

Corinne Babiolakis ◽

Maggie Hulbert ◽

Mandy E Turner ◽

...

Keyword(s):

Insulin Resistance ◽

Clinical Judgment ◽

Healthy Aging ◽

Linear Models ◽

Unintended Consequences ◽

Wilcoxon Test ◽

General Linear ◽

Model Assessment ◽

Lateral Spine ◽

Statin Use

Abstract Context Statins have been linked to the development of diabetes and atherosclerotic plaque calcification in patients with cardiac disease. Objective To determine the association between statin use and statin characteristics and insulin resistance and abdominal aortic calcification (AAC) in participants of the Canadian Multicentre Osteoporosis Study (CaMos). Design Observational study. Setting General community. Participants Nondiabetic participants of the Kingston CaMos site Intervention Insulin resistance and AAC in statin users and nonstatin users were compared with and without the inclusion of a propensity score (PS) to be on a statin. The covariates of hypertension, sex, body mass index, smoking, kidney stones, and age that were included in the PS were selected based on clinical judgment confirmed by the statistical analysis of a difference between statin users and nonstatin users. Main Outcome Measures Insulin resistance measured by the homeostasis model assessment (HOMA-IR) and AAC assessed on lateral spine radiographs using the Framingham methodology. Results Using a general linear model, statin use was associated with higher levels of HOMA-IR after stratified PS adjustment (β = 1.52, [1.18–1.95], P < 0.01). Hydrophilic statin users (n = 9) and lipophilic statins users (n = 30) had higher HOMA-IR compared to nonstatin users (n = 125) ([β = 2.29, (1.43–3.68), P < 0.001] and [β = 1.36, (1.04–1.78), P < 0.05]), respectively, in general linear models after stratified PS adjustment. Statin use was associated with AAC without stratifying by PS in the Wilcoxon test, but was no longer significant when stratified by PS. Conclusions Statins, widely prescribed drugs to lower cholesterol, may have unintended consequences related to glucose homeostasis that could be relevant in healthy aging.

Download Full-text