scholarly journals Beyond Bone Mineral Density: A New Dual X-Ray Absorptiometry Index of Bone Strength to Predict Fragility Fractures, the Bone Strain Index

2021 ◽  
Vol 7 ◽  
Author(s):  
Fabio Massimo Ulivieri ◽  
Luca Rinaudo
Keyword(s):  
Bone Mineral Density ◽  
Density Distribution ◽  
Bone Strength ◽  
Bone Quality ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Bone Strain ◽  
Mineral Density ◽  
Strain Index ◽  
X Ray

For a proper assessment of osteoporotic fragility fracture prediction, all aspects regarding bone mineral density, bone texture, geometry and information about strength are necessary, particularly in endocrinological and rheumatological diseases, where bone quality impairment is relevant. Data regarding bone quantity (density) and, partially, bone quality (structure and geometry) are obtained by the gold standard method of dual X-ray absorptiometry (DXA). Data about bone strength are not yet readily available. To evaluate bone resistance to strain, a new DXA-derived index based on the Finite Element Analysis (FEA) of a greyscale of density distribution measured on spine and femoral scan, namely Bone Strain Index (BSI), has recently been developed. Bone Strain Index includes local information on density distribution, bone geometry and loadings and it differs from bone mineral density (BMD) and other variables of bone quality like trabecular bone score (TBS), which are all based on the quantification of bone mass and distribution averaged over the scanned region. This state of the art review illustrates the methodology of BSI calculation, the findings of its in reproducibility and the preliminary data about its capability to predict fragility fracture and to monitor the follow up of the pharmacological treatment for osteoporosis.

scholarly journals Evaluation of relationship between bone mineral density and fragility fracture in perimenopausal women between 40-58 years of age: a hospital based prospective observational study

2019 ◽  
Vol 5 (4) ◽  
pp. 605
Author(s):  
Arvind Kumar ◽  
Mozammil Pheroz ◽  
Rajesh K. Chopra ◽  
Benthungo Tungoe ◽  
Narendra Kumar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Assessment ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
Left Femur ◽  
X Ray ◽  
Total Hip ◽  
Perimenopausal Women ◽  
Bony Injury

<p class="abstract"><strong>Background:</strong> At present the risk assessment for osteoporosis using low bone mineral density (BMD) is based on data obtained from elderly females, largely ≥ 65 years of age. The risk factors for low peak bone mass or accelerated bone loss that occurs during perimenopausal phase is ignored in this risk assessment. Osteoporosis is found to occur at a relatively younger age in the Indian population. Although lower BMD values have an established identity as a major risk factor for fractures in postmenopausal women, we endeavour to evaluate relationship between bone mineral density and fragility fracture in perimenopausal women.</p><p class="abstract"><strong>Methods:</strong> 65 Patients were recruited for the study. After X-ray of involved part, patients were divided into cases (with fracture, n=33) and control (no bony injury, n=32). All patients underwent dual energy X-ray absorptiometry (DEXA) scan. Results of DEXA scans were evaluated in both the groups. BMD was expressed in g/cm<sup>2</sup>.<strong></strong></p><p class="abstract"><strong>Results:</strong> 33 patients (50.77%) were diagnosed as fracture, 32(49.23%) had no bony injury. Threshold bone mineral density (BMD) for fragility fracture found out asfor L1, cut off ≤0.767. For L2, cut off ≤0.829. For L3, cut off ≤0.811. L4, cut off ≤0.798. For L1-L4, cut off ≤0.845. For left femur total hip, cut off ≤0.918. For left forearm-total, cut off ≤0.411. For right femur total hip-cut off ≤0.795. For right forearm-total, cut-off≤0.382.</p><p class="abstract"><strong>Conclusions:</strong> Perimenopausal women having BMD below threshold for involved site are at risk of fragility fracture and should be given prophylactic treatment to improve bone mineral density.</p>

scholarly journals Bone quality: what is it and how is it measured?

2006 ◽  
Vol 50 (4) ◽  
pp. 579-585 ◽  
Author(s):  
Juliet Compston
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Bone Strength ◽  
Bone Quality ◽  
Bone Mineral ◽  
Bone Matrix ◽  
Mineral Density ◽  
New Techniques ◽  
Composition And Structure

Bone quality describes aspects of bone composition and structure that contribute to bone strength independently of bone mineral density. These include bone turnover, microarchitecture, mineralisation, microdamage and the composition of bone matrix and mineral. New techniques to assess these components of bone quality are being developed and should produce important insights into determinants of fracture risk in untreated and treated disease.

Bone mineral density distribution in thoracic and lumbar vertebrae: An ex vivo study using dual energy X-ray absorptiometry

Bone ◽  
2006 ◽  
Vol 38 (2) ◽  
pp. 286-288 ◽  
Author(s):  
Andrew M. Briggs ◽  
John D. Wark ◽  
Susan Kantor ◽  
Nicola L. Fazzalari ◽  
Alison M. Greig ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Density Distribution ◽  
Bone Mineral ◽  
Ex Vivo ◽  
Lumbar Vertebrae ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
Ex Vivo Study ◽  
Bone Mineral Density Distribution

scholarly journals The Use of CT Hounsfield Unit Values to Identify The Bone Quality in Patients With Cervical Degenerative Diseases.

2020 ◽  
Author(s):  
Lei He ◽  
Fei Fei Zhou ◽  
Yu Sun ◽  
Wei-Shi Li
Keyword(s):  
Bone Mineral Density ◽  
Bone Quality ◽  
Bone Mineral ◽  
Cervical Vertebrae ◽  
Hounsfield Unit ◽  
Dual Energy ◽  
Degenerative Diseases ◽  
Mineral Density ◽  
X Ray ◽  
T Score

Abstract Background It is well known that osteoporosis may lead to the failure of spinal surgery. As the gold standard, dual-energy X-ray absorptiometry (DXA) is used to evaluate the overall bone mineral density (BMD). Previous studies have used CT (Computed tomography) value to evaluate local bone mineral density. The objective of this study was to investigate the application value of cervical CT value in preoperative bone quality evaluation of cervical degenerative diseases. Methods A total of 939 patients who received surgical treatment for cervical degenerative diseases in our center from January 2015 to December 2017 were retrospectively reviewed. The Hounsfield unit (HU) values were measured in middle transverse CT images of the C2–C7 on the picture archiving and communication system (PACS), and the total bone mineral density T-score of L1–L4 was obtained by dual-energy X-ray absorptiometry. The changes in the HU values of C2–C7 were observed, the correlation between the HU value of C2–C7 and the total BMD T-score of L1–L4 was analyzed, and the HU thresholds of C2–C7 for different T-scores (-2.5 < T-score <-1 or T-score ≤2.5, respectively) were identified. Results The HU values of C2–C7 show a decreasing trend. The mean HU value of C2–C7 was 322.52 ± 89.27 HU. The average BMD T-score of L1-L4 was -0.73. The average HU value of C2–C7 was positively correlated with the average BMD T-score of L1–L4 (r = 0.487, P < 0.001). The HU threshold of C2–C7 was 269 HU when -2.5＜T-score＜-1, and it had a sensitivity of 75.7% and a specificity of 59.8% when used for screening for osteopenia; the HU threshold of C2–C7 was 269H U when T-score ≤-2.5, and it had a sensitivity of 63.8% and a specificity of 80.8% when used for screening for osteoporosis. Conclusions The HU values of cervical vertebrae gradually decrease from C2 to C7 in patients undergoing surgical treatment for cervical degenerative disorders. The CT HU value of cervical vertebrae is positively correlated with the BMD T-score provided by lumbar DXA, which is helpful for clinical evaluation of bone quality before surgery.

scholarly journals The Effects of Combination of Alendronate and Human Parathyroid Hormone(1–34) on Bone Strength Are Synergistic in the Lumbar Vertebra and Additive in the Femur of C57BL/6J Mice

Endocrinology ◽  
2007 ◽  
Vol 148 (9) ◽  
pp. 4466-4474 ◽  
Author(s):  
Sara Johnston ◽  
Sharon Andrews ◽  
Victor Shen ◽  
Felicia Cosman ◽  
Robert Lindsay ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Density ◽  
Bone Strength ◽  
Bone Quality ◽  
Bone Mineral ◽  
Bone Markers ◽  
Bone Structure ◽  
Human Study ◽  
Quantitative Computed Tomography ◽  
Mineral Density

A cyclic PTH regimen is as effective as a daily regimen on bone density gain in humans and in improving bone quality in mice. Our previous murine study evaluated the effects of a cyclic PTH regimen in the absence of a bisphosphonate, whereas our human study addressed the effects of a cyclic PTH regimen in the presence of ongoing alendronate (ALN) treatment. Accordingly, the current study examined the effects of cyclic or daily PTH regimens in combination with ALN on bone quality and bone density in mice. Twenty-week-old, female C57BL/6J mice were treated with the following sc injections (n = 10): 1) vehicle for 5 d/wk (control); 2) ALN (20 μg/kg·d) 3 d/wk (ALN); 3) human PTH(1–34) (40 μg/kg·d) 5 d/wk (daily PTH); 4) daily PTH in addition to ALN (daily PTH plus ALN); 5) PTH 5 d/wk and vehicle 5 d/wk alternating weekly (cyclic PTH); 6) cyclic PTH in addition to ALN (cyclic PTH plus ALN); and 7) PTH and ALN alternating weekly (alt PTH and ALN). Bone mineral density was measured weekly by dual-energy x-ray absorptiometry, and at 7 wk, bone markers, bone structure, and bone strength were evaluated by biochemical assays, peripheral quantitative computed tomography and mechanical testing, respectively. At 7 wk, all treatments significantly increased femoral and vertebral bone mineral density. ALN slightly decreased endosteal circumference, whereas PTH increased periosteal circumference, resulting in significant increases in femoral cortical thickness in all groups. PTH and ALN enhanced bone strength synergistically in the lumbar vertebrae and additively in the femur. Combined therapy, however, had no effects on bone markers. The results show that combinations of ALN and PTH, in both daily and cyclic regimens, produce more beneficial effects than treatment with either agent alone, suggesting that the mechanisms of actions of ALN and PTH on bone quality may be complementary.

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