scholarly journals Preoperative measures of bone mineral density from digital wrist radiographs

2021 ◽  
Vol 10 (12) ◽  
pp. 830-839 ◽  
Author(s):  
Greg Robertson ◽  
Robert Wallace ◽  
A. Hamish R. W. Simpson ◽  
Sarah P. Dawson
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Pearson Correlation ◽  
Region Of Interest ◽  
Alternative Methods ◽  
Mineral Density ◽  
Distal Radial Fractures ◽  
X Ray ◽  
Digital Radiographs ◽  
Grading Systems

Aims Assessment of bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) is a well-established clinical technique, but it is not available in the acute trauma setting. Thus, it cannot provide a preoperative estimation of BMD to help guide the technique of fracture fixation. Alternative methods that have been suggested for assessing BMD include: 1) cortical measures, such as cortical ratios and combined cortical scores; and 2) aluminium grading systems from preoperative digital radiographs. However, limited research has been performed in this area to validate the different methods. The aim of this study was to investigate the evaluation of BMD from digital radiographs by comparing various methods against DXA scanning. Methods A total of 54 patients with distal radial fractures were included in the study. Each underwent posteroanterior (PA) and lateral radiographs of the injured wrist with an aluminium step wedge. Overall 27 patients underwent routine DXA scanning of the hip and lumbar spine, with 13 undergoing additional DXA scanning of the uninjured forearm. Analysis of radiographs was performed on ImageJ and Matlab with calculations of cortical measures, cortical indices, combined cortical scores, and aluminium equivalent grading. Results Cortical measures showed varying correlations with the forearm DXA results (range: Pearson correlation coefficient (r) = 0.343 (p = 0.251) to r = 0.521 (p = 0.068)), with none showing statistically significant correlations. Aluminium equivalent grading showed statistically significant correlations with the forearm DXA of the corresponding region of interest (p < 0.017). Conclusion Cortical measures, cortical indices, and combined cortical scores did not show a statistically significant correlation to forearm DXA measures. Aluminium-equivalent is an easily applicable method for estimation of BMD from digital radiographs in the preoperative setting. Cite this article: Bone Joint Res 2021;10(12):830–839.

Dual-energy digital radiography for the assessment of bone mineral density

2010 ◽  
Vol 51 (5) ◽  
pp. 543-548 ◽  
Author(s):  
Päivi S. Tahvanainen ◽  
Eveliina Lammentausta ◽  
Pasi Pulkkinen ◽  
Osmo Tervonen ◽  
Timo Jämsä ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Digital Radiography ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
Digital Radiographs ◽  
Geometrical Information ◽  
Linear Correlations

Background: Bone mineral density (BMD) is usually determined by dual-energy X-ray absorptiometry (DXA). Digital radiography (DR) has enabled the application of dual-energy techniques for separating bone and soft tissue, but it is not clear yet whether BMD information can reliably be obtained using DR. Purpose: To determine the ability of dual-energy digital radiography (DEDR) to predict BMD as determined by DXA. Material and Methods: Reindeer femora ( n=15) were imaged in a water bath at a typical clinical imaging voltage of 79 kVp and additionally at 100 kVp on a DR system. BMD was determined in four segmented regions (femoral neck, trochanter, inter-trochanter, Ward's triangle) from these images using the DXA calculation principle. BMD results as determined by DEDR were compared with BMD values as determined by DXA. Results: Significant moderate to high linear correlations (0.66–0.76) were observed at the femoral neck, Ward's triangle, and trochanter between BMD values as determined by the two techniques. The coefficient of variation (CVRMS) ranged between 2.2 and 4.7% and 0.2 and 1.8% for DEDR and DXA analyses, respectively. Conclusion: DXA-based BMD information can be obtained with moderate precision and accuracy using DEDR. In future, combining BMD measurements using DEDR with structural and geometrical information available on digital radiographs could enable a more comprehensive assessment of bone.

scholarly journals Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8144
Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Oral Bisphosphonates ◽  
Mineral Density ◽  
X Ray ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

scholarly journals POS0045 LEAST SIGNIFICANT CHANGE IN BONE DENSITOMETRY IN PATIENTS WITH OBESITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 227.2-228
Author(s):  
D. Claire ◽  
M. Geoffroy ◽  
L. Kanagaratnam ◽  
C. Isabelle ◽  
A. Hittinger ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
General Population ◽  
Bone Mineral ◽  
Bone Densitometry ◽  
Dual Energy ◽  
Mineral Density ◽  
Least Significant Change ◽  
X Ray ◽  
Significant Change

Background:Dual energy X-ray absoprtiometry is the reference method to mesure bone mineral density (1). Loss of bone mineral density is significant if it exceeds the least significant change. The threshold value used in general population is 0,03 g/cm2 (2). Patients with obesity are known for having a higher bone mineral density due to metabolism and physiopathology characteristics (3,4).Objectives:The aim of our study was to determine the least significant change in bone densitometry in patients with obesity.Methods:We conducted an interventionnal study in 120 patients with obesity who performed a bone densitometry. We measured twice the bone mineral density at the lumbar spine, the femoral neck and the total hip in the same time (5,6). We determined the least significant change in bone densitometry from each pair of measurements, using the Bland and Altman method. We also determined the least significant change in bone densitometry according to each stage of obesity.Results:The least significant change in bone densitometry in patients with obesity is 0,046g/cm2 at the lumbar spine, 0.069 g/cm2 at the femoral neck and 0.06 g/cm2 at the total hip.Conclusion:The least significant change in bone densitometry in patients with obesity is higher than in general population. These results may improve DXA interpretation in this specific population, and may personnalize their medical care.References:[1]Lees B, Stevenson JC. An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporos Int. mai 1992;2(3):146-52.[2]Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum. oct 2018;85(5):428-40.[3]Shapses SA, Pop LC, Wang Y. Obesity is a concern for bone health with aging. Nutr Res N Y N. mars 2017;39:1-13.[4]Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. juin 2018;17(2):205-17.[5]Roux C, Garnero P, Thomas T, Sabatier J-P, Orcel P, Audran M, et al. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Jt Bone Spine Rev Rhum. janv 2005;72(1):26-31.[6]Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res. août 1999;14(8):1449-56.Disclosure of Interests:None declared.

The relation between AO-classification of distal radial fractures and bone mineral density

Injury ◽  
2013 ◽  
Vol 44 (11) ◽  
pp. 1657-1658 ◽  
Author(s):  
Gijs de Klerk ◽  
J. Han Hegeman ◽  
Henk Jan ten Duis
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Density ◽  
Distal Radial Fractures ◽  
Ao Classification

93 Does Spinal Bone Mineral Density Predict An Absolute 10 Year Probability of Sustaining A Major Osteoporotic Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Nandi ◽  
N Obiechina ◽  
A Timperley ◽  
F Al-Khalidi
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Negative Correlation ◽  
Pearson Correlation ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
T Score ◽  
The Mean

Abstract Introduction Spine and hip bone mineral density (BMD) have previously been shown to predict the risk of sustaining future fractures. Although these have been shown in population studies, there is a paucity of trials looking at the relationship between BMD and 10 year probability of major osteoporotic fractures (Using FRAX UK without BMD) in patients with previous fragility fractures. Aims To evaluate the correlation between spinal T-score and an absolute 10 year probability of sustaining a major osteoporotic fracture (using FRAX without BMD) in patients with prior fragility fractures. Methods A retrospective cross-sectional analysis of 202 patients (29 males and 173 females) with prior fragility fractures attending a fracture prevention clinic between January and August 2019 was performed. Patients with pathological and high impact traumatic fractures were excluded. The BMD at the spine was determined using the lowest T-score of the vertebrae from L1 to L4. Using the FRAX (UK) without BMD, the absolute 10 year probability of sustaining a major osteoporotic fracture was calculated for each patient. Statistical analysis was performed using SPSS 26 software. Results The mean T-score at the spine was −1.15 (SD +/− 1.90) for all patients, −0.68 (SD +/− 0.45) for males and − 1.23 (SD +/− 0.14) for females. The mean FRAX score without BMD for major osteoporotic fracture was 18.5% (SD +/− 8.84) for all patients, 11.41% (SD +/−0.62) and 19.7% (SD +/−0.68) for males and females respectively. Pearson correlation coefficient showed a statistically significant, slightly negative correlation between spinal T- score and the FRAX (UK) without BMD (r = −0.157; p &lt; 0.05). Correlation was not statistically significant when males (r = 0.109; p = 0.59) and females (r = 0.148; p = 0.053) were considered independently. Conclusion In patients with prior fragility fracture spinal BMD has a statistically significant negative correlation with an absolute 10 year probability of sustaining a major osteoporotic fracture.

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