Distal radial cortical bone thickness correlates with bone mineral density and can predict osteoporosis: a cohort study

Chunxiao Ye,Yingbin Guo,Youhui Zheng,Zhenbin Wu,Kaiyu Chen,Xiaoling Zhang,Liangxiu Xiao,Zhiming Chen

doi:10.1016/j.injury.2020.08.018

Abstract

PurposeThe purpose of this study was to evaluate the correlation of the bone mineral density (BMD) of the hip and lumbar spine with the distal radius cortical thickness (DRCT) measured on anteroposterior radiographs and establish a method for predicting osteoporosis. MethodsWe assessed 147 patients aged ≥50 years with distal radius fractures who underwent wrist radiographs and dual-energy X-ray absorptiometry. The DRCT was measured and calculated at two levels of the distal radius of the injured wrist on the radiographs. ResultsThe intra-rater and inter-rater reliability of measures was excellent (intraclass correlation coefficient >0.85). In the Pearson correlation and simple linear regression analyses, the DRCT was positively correlated with hip BMD (r = 0.393, P < 0.01) and lumbar spine BMD (r = 0.529, P < 0.01). Each 1-mm increase in DRCT was associated with a 0.051-g/cm2 increase in hip BMD (R2 = 0.154, P < 0.01) and a 0.080-g/cm2 increase in lumbar spine BMD (R2 = 0.280, P < 0.01). A DRCT of 5.1 mm was selected as the cutoff point for predicting osteoporosis, with the highest Youden index of 0.560, 83.3% sensitivity, 72.7% specificity, and a 66.7% negative predictive value. ConclusionCortical thickness measurements obtained from anteroposterior wrist radiographs were positively correlated with hip and lumbar spine BMD measurements. This technique is suggested as a rapid, inexpensive, and sensitive method for predicting osteoporosis. Level of evidenceDiagnostic II

Highlights

We evaluated the correlation of the bone mineral density (BMD) of the hip and lumbar spine with the distal radius cortical thickness (DRCT) measured on anteroposterior radiographs to establish a method for predicting osteoporosis
Studies have demonstrated that a high proportion of patients with distal radius fractures have low bone mineral density (BMD) [4,5,6], indicating that this type of fracture might be the first manifestation of osteoporosis
Linear regression analysis showed that DRCT was positively correlated with hip BMD (r = 0.393, P = 0.000) and lumbar spine BMD (r = 0.529, P = 0.000) and that the cortex ratio was positively correlated with hip BMD (r = 0.337, P = 0.000) and lumbar spine BMD (r = 0.414, P = 0.000)

Summary

Introduction

We evaluated the correlation of the bone mineral density (BMD) of the hip and lumbar spine with the distal radius cortical thickness (DRCT) measured on anteroposterior radiographs to establish a method for predicting osteoporosis. Methods We assessed 147 patients aged ≥50 years with distal radius fractures who underwent wrist radiographs and dual-energy X-ray absorptiometry. A fracture of the distal part of the radius is one of the most common types of fracture, and its incidence increases with age, in female patients [1]. Such fractures have been shown to be associated with osteoporosis [1,2,3]. Studies have demonstrated that a high proportion of patients with distal radius fractures have low bone mineral density (BMD) [4,5,6], indicating that this type of fracture might be the first manifestation of osteoporosis. A large number of patients with fractures related to osteoporosis are not evaluated and treated for osteoporosis [9,10,11]

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