Assessment of distal forearm dexa scan as a screening tool for primary osteoporotic fractures of distal end radius in postmenopausal women

Abstract

Abstract Background: Fragility fractures, which most typically afflict postmenopausal women’s wrists, hips, and spines, are frequently caused by osteoporosis. In comparison to other times and places, the incidence is approximately two times higher during perimenopause. The risk of future wrist fractures is markedly increased by a prior fracture. Many studies have emphasized the importance of screening as a preventative measure against future fractures in these people with osteoporosis. This study aimed to assess the utility of distal forearm dual-energy X-ray absorptiometry (DEXA) as a screening tool to assess the risk of development of primary osteoporotic fractures at the distal end radius (DER) in postmenopausal women. Objectives: The study’s objective was to determine whether DEXA at the distal end of the radius could be used as a screening technique to determine the fragility fractures. Materials and Methods: The method followed included a cross-sectional study conducted on 60 patients (30 in group A: postmenopausal women with DER fracture, and 30 in group B: postmenopausal women without fractures), who fulfilled the inclusion criteria. Results: All patients underwent DEXA scan at three sites (hip, spine, and distal radius). On comparison of T-score between Hip, Spine, DER in group A , T-score with value <−2.5 was 53.33% at Hip, 70% at Spine and 70 % at DER with Total of 64.44%. mean±S.D at Hip was −2.73±1.27, at Spine was −3.23±1.25 and at DER was −3.42±162. P-value 57 was 0.298, Hip vs Spine: 0.184 , Hip vs DER : 0.184, Spine vs DER : 1. On comparison of Tscore between Hip, Spine, DER in group B, T-score with value <−2.5 was 30% at Hip, 56.67% at Spine, 13.33% at DER with total of 33.33%. mean±SD was −2.09±0.9 at Hip, −2.54±1.32 at Spine and −1.64±0.78 at DER. P-value was 0.002,Hip vs Spine : 0.037, Hip vs DER: 0.209, spine vs DER: 0.0009. this supports above study and we can use DER DEXA Scan as a screening tool in postmenopausal women. There was a significant deterioration of T-score at DER and hip and spine in the fracture group compared with the control group (P < 0.001). Conclusion: Some postmenopausal women showed preferential bone loss at the distal region of the radius, which would make them more susceptible to fragility fractures there. In general, forearm DXA for the evaluation of local bone density may prove beneficial to screening people at risk for distal radial fractures and makes it easier to identify patients who need osteoporosis treatment early on.