Abstract
Patients suffering from rheumatic inflammatory diseases, e.g., systemic sclerosis, rheumatoid arthritis, and ankylosing spondylitis, are at risk of low bone mass. Dual-energy X-ray Absorptiometry (DXA) is the traditional radiological measurement technique for bone mineral density (BMD). The recently developed trabecular bone score (TBS) enhances the skeletal information provided by standard BMD. It re-analyzes the spatial dynamics of pixel intensity changes in lumbar spine DXA images, defining a quantitative index, characterizing trabecular bone microarchitecture. It has been demonstrated that low TBS values are associated with an increased incidence of fractures in patients with rheumatic diseases. These methods used together for bone damage evaluation can be of value to identify individuals who will potentially fracture. The main scientific literature on the clinical aspects of osteoporosis, including the use of TBS in evaluating this pathology, are herein reported aimed at shedding light on the role trabecular bone score plays in chronic inflammatory rheumatic diseases.
Highlights
The trabecular bone score (TBS) a grayscale measurement of texture which is derived from the evaluation of the experimental variogram obtained from the Dual-energy X-ray Absorptiometry (DXA) images, is a relatively new tool to evaluate bone microarchitecture [1]
This study showed that systemic lupus erythematosus (SLE) patients had an increased prevalence of 25(OH) vitamin D insufficiency (p < 0.001) than healthy subjects (HS), as frequently reported in rheumatic diseases [36, 40]
The bone mineral density (BMD) values and the T-score measured on the vertebral column, the femoral neck, and the whole femur were significantly lower in rheumatoid arthritis (RA) patients than those in the control group Lumbar spine TBS was found significantly lower in RA patients compared with mHC
Summary
The trabecular bone score (TBS) a grayscale measurement of texture which is derived from the evaluation of the experimental variogram obtained from the Dual-energy X-ray Absorptiometry (DXA) images, is a relatively new tool to evaluate bone microarchitecture [1]. Lai et al and Ruaro et al emphasized the important role TBS plays as an innovative and safe diagnostic tool for the quantification of bone quality in chronic and systemic inflammatory rheumatic diseases, such as those observed in SLE Both studies confirmed that SLE patients have a higher risk of bone loss (osteopenia and OP) and fractures than do HS [34, 40]. These data could overcome the bias derived from previous reports with falsely elevated DXA values at the level of the lumbar spine in AS [49,50,51] This finding is most likely due to the fact that DXA measures only the quantity and not the quality of the bone, confirming its limitations for fracture prediction in this patient group.
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