Abstract
ObjectiveReduced bone mineral density (BMD), assessed by Dual Energy X-ray absorptiometry (DXA), is a well-known risk factor for fragility fracture. A large proportion of patients with fracture have only slightly reduced BMD. Assessment of other bone structure features than BMD may improve identification of individuals at increased fracture risk. Digital X-ray radiogrammetry (DXR), which is a feasible tool for measurement of metacarpal cortical bone density, also gives an estimate of cortical bone porosity. Our primary aim was to explore the association between cortical porosity in the hand assessed by DXR and distal radius fracture.MethodsThis case-control study included 123 women >50 years with distal radius fracture, and 170 controls. DXR was used to measure metacarpal BMD (DXR-BMD), cortical porosity (DXR-porosity), thickness (DXR-CT) and bone width (DXR-W) of the hand. Femoral neck BMD was measured by DXA.ResultsThe fracture group had a statistically significant lower DXR-BMD (0.492 vs. 0.524 g/cm2 p<0.001), higher cortical DXR-porosity (0.01256 vs. 0.01093, p<0.001), less DXR-CT (0.148 vs. 0.161cm, p<0.001) and lower femoral neck DXA-BMD (0.789 vs. 0.844 g/cm2, p = 0.001) than the controls. In logistic regression analysis adjusted for age, a significant association with distal radius fracture (OR, 95% CI) was found for body mass index (0.930, 0.880–0.983), DXA-BMD (0.996, 0.995–0.999), DXR-BMD (0.990, 0.985–0.998), DXR-porosity (1.468, 1.278–1.687) and DXR-CT (0.997, 0.996–0.999). In an adjusted model, DXR-porosity remained the only variable associated with distal radius fracture (1.415, 1.194–1.677).ConclusionDXR derived porosity is associated with fracture at distal radius and might be a sensitive marker for skeletal fragility.
Highlights
Distal radius is one of the most common sites for osteoporotic fractures in middle aged and elderly women [1]
In logistic regression analysis adjusted for age, a significant association with distal radius fracture (OR, 95% CI) was found for body mass index (0.930, 0.880–0.983), Dual Energy X-ray Absorptiometry (DXA)-bone mineral density (BMD) (0.996, 0.995–0.999), digital X-ray radiogrammetry (DXR)-BMD (0.990, 0.985–0.998), DXR-porosity (1.468, 1.278–1.687) and DXR-CT (0.997, 0.996–0.999)
Our understanding of fracture risk at sites dominated by cortical bone has developed beyond consideration of bone density alone [9,10,11,12,13].The digital X-ray radiogrammetry (DXR), a computer version of the traditional metacarpal radiogrammetry, is a feasible method developed primarily for the estimation of metacarpal cortical hand BMD on hand radiographs [14]
Summary
Distal radius is one of the most common sites for osteoporotic fractures in middle aged and elderly women [1]. Our understanding of fracture risk at sites dominated by cortical bone has developed beyond consideration of bone density alone [9,10,11,12,13].The digital X-ray radiogrammetry (DXR), a computer version of the traditional metacarpal radiogrammetry, is a feasible method developed primarily for the estimation of metacarpal cortical hand BMD on hand radiographs [14]. The main objective of this study was to explore the association between increased cortical bone porosity assessed by the DXR software (DXRporosity), and distal radius fragility fracture in middle-aged and elderly women
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
