Metacarpal Bone Mass Research Articles

Influence of angulation on metacarpal bone mineral density measurements using digital X-ray radiogrammetry.

Digital X-ray radiogrammetry (DXR) is a computer-assisted technique used to quantify cortical bone density of the metacarpals. The influence of metacarpal bone rotation and type of cast material on bone mineral density (BMD) measurements using the DXR technique was tested. The bone mineral density of the hand was measured by DXR, and rotation error (DXR-RE) as coefficients of variation were calculated, to verify reliability and reproducibility of this radiogeometric technique to assess in particular minor disease-related changes in the metacarpal bone mass. The reproducibility of the DXR measurements was also investigated using different cast materials (mull, elastic, and plastic). There were no significant changes in absolute values of DXR-BMD observed between 0 to [Formula: see text] angulation. The relative DXR-RE ranged between 0 % (degree 1) and 0.70 % (degrees 15 and 19) for DXR-BMD. Regarding the different cast materials, DXR-BMD revealed a coefficient of variation with 0.41 % (mull cast) and 0.21 % (elastic cast). For the plastic cast, the DXR technique was not able to perform an analysis of DXR-BMD. The study revealed no significant influence of metacarpal rotation on the measurements of metacarpal bone mineral density as estimated by DXR. DXR measurements are not optimal when cast material is used. DXR can accurately quantify periarticular cortical bone mass. This is significant especially for rheumatoid arthritis and related conditions where X-ray imaging of arthritic hands with varying degrees of deformity is performed.

One-year change in the second metacarpal bone mass associated with menopause nutrition and physical activity

One-year change in the second metacarpal bone mass associated with menopause nutrition and physical activity

One-year change in the second metacarpal bone mass associated with menopause nutrition and physical activity.

To clarify the annual changes and effects of nutrition and physical activity on bone mass at the second metacarpal using computed X-ray densitometry. Population-based prospective follow-up study. Bone mass measurements and assessments of nutritional intake, exercise habits, and health status were conducted twice with a one-year interval. 269 Japanese women aged 40 - to -80 - years old. The annual change rate among subjects who started menopause during the observation period was -4.2 +/- 4.9%. Bone mass subsequently continued to decrease 3% annually until 6 years after menopause. Subjects who consumed high levels of milk or calcium in the first year showed no substantial decrease in bone mass among the post-menopausal subjects. Premenopausal subjects who began or continued exercise evidenced increased bone mass, and peri-menopausal subjects who continued exercise or a high level of daily physical activity showed inhibited bone loss. Second metacarpal bone changed by menopause, nutrition and physical activity similar with other bone site presented in the previous studies.

High bone mass as a marker for breast cancer risk.

Postmenopausal women in the highest quartile for metacarpal bone mass were found to have an increased risk of developing breast cancer, after adjusting for age and other variables known to influence breast cancer risk. Although the mechanisms responsible for this relationship have not been identified, postmenopausal bone mass may serve as an indicator of cumulative estrogen exposure.

Quantitative genetics of cortical bone mass in healthy 10-year-old children from the Fels Longitudinal Study

The genetic influences on bone mass likely change throughout the life span, but most genetic studies of bone mass regulation have focused on adults. There is, however, a growing awareness of the importance of genes influencing the acquisition of bone mass during childhood on lifelong bone health. The present investigation examines genetic influences on childhood bone mass by estimating the residual heritabilities of different measures of second metacarpal bone mass in a sample of 600 10-year-old participants from 144 families in the Fels Longitudinal Study. Bivariate quantitative genetic analyses were conducted to estimate genetic correlations between cortical bone mass measures, and measures of bone growth and development. Using a maximum likelihood-based variance components method for pedigree data, we found a residual heritability estimate of 0.71 for second metacarpal cortical index. Residual heritability estimates for individual measures of cortical bone (e.g., lateral cortical thickness, medial cortical thickness) ranged from 0.47 to 0.58, at this pre-pubertal childhood age. Low genetic correlations were found between cortical bone measures and both bone length and skeletal age. However, after Bonferonni adjustment for multiple testing, ρ G was not significantly different from 0 for any of these pairs of traits. Results of this investigation provide evidence of significant genetic control over bone mass largely independent of maturation while bones are actively growing and before rapid accrual of bone that typically occurs during puberty.

Relationships among physical activity, metacarpal bone mass, and bone resorption marker in 70 healthy adult males

The purpose of the present study was to investigate the relationships among physical activity, metacarpal bone mineral density (BMD), and bone resorption marker in healthy active adult men. Seventy healthy men (mean age, 68.4 years, range, 48–85 years) were recruited. The metacarpal BMD of the nondominant hand was measured by computed X-ray densitometry, and the levels of urinary cross-linked N-telopeptides of type I collagen (NTx), as a marker of bone resorption, were measured with an enzyme-linked immunosorbent assay. The relationships among BMD, urinary NTx levels, and activities in leisure time and at work were examined. BMD was 2.77 ± 0.48 (mean ± SD; range, 1.54–3.60) mmAl, and NTx levels were 44.9 ± 21.0 (range, 11.7–91.0) nmol BCE/mmol creatinine. Single regression analysis showed that BMD was significantly correlated with NTx levels and activity at work (r= -0.331 and P < 0.01; r= 0.468 and P < 0.05, respectively), while NTx levels were significantly correlated with activities in leisure time and at work (r = -0.250 and P < 0.01; r= -0.325 and P < 0.01, respectively). NTx levels were decreased and BMD were increased with higher activity at work. The present study shows that increased physical activity as a result of hard work may have the potential to decrease bone resorption and increase BMD in healthy adult men.

Relationships between physical activity and metacarpal cortical bone mass and bone resorption in hemiplegic patients

The aim of the present study was to investigate the relationships between physical activity and metacarpal cortical bone mineral density (BMD) and bone resorption in hemiplegic patients. Seventy-two male hemiplegic patients with cerebrovascular disease (mean age, 67.0 years; range 48–83 years) were recruited. Metacarpal cortical BMD in bilateral hands was measured by computed X-ray densitometry, and the levels of urinary cross-linked N-telopeptides of type I collagen (NTx), as a bone resorption marker, were measured by an enzyme-linked immunosorbent assay (ELISA). BMD (mean±SD) in the paralyzed hand was significantly lower than that in the nonparalyzed hand (2.52±46 and 2.64±0.45 mmAl; P<0.05). On multiple regression analysis, BMD was significantly positively correlated with Brunnstrom stage (assessment of degree of paralysis) in the hand (P<0.05), whereas urinary NTx levels were significantly negatively correlated with Brunnstrom stage in the hand, arm, and leg, and with walking ability (P<0.05, P<0.05, P<0.01, and P<0.01, respectively). These findings suggest that, in male hemiplegic patients, although metacarpal cortical BMD may be affected by only local physical activity, urinary NTx appears to be responsive to local and general physical activity.

Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitudinal study.

offerosclerosis and osteoporosis are major causes of morbidity and mortality in postmenopausal women and have been suggested to be associated. No study has examined whether progression of atherosclerotic calcification is associated with bone loss. In the present study, we examined progression of aortic calcification, diagnosed by radiographic detection of calcified deposits in the abdominal aorta, in relation to metacarpal bone loss, as assessed by metacarpal radiogrammetry, during menopause. Initially premenopausal women (n=236), aged 45 to 57 years at baseline, were followed for 9 years. We additionally assessed the cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density in 720 postmenopausal women. Twenty-five percent of women going through menopause showed progression of aortic calcification. The average loss of metacarpal bone mass among women with progression of aortic calcification was 3.2 mm(2), and their loss of metacarpal bone density was 7.2 mm(2) %, whereas in women without progression of aortic calcification, these losses were 2.0 mm(2) and 5.6 mm(2) %, respectively, adjusted for age and years of follow-up (P<0.05). Additional adjustment for age at menopause, body mass index, blood pressure, smoking, diabetes mellitus, and use of hormone replacement therapy, thiazide, and loop diuretics did not influence these results. In postmenopausal women, a graded inverse cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density was found. In conclusion, our results indicate that progression of atherosclerotic calcification is associated with increased bone loss in women during menopause.

Age-related changes in cortical bone in men: metacarpal bone mass measurement study

Metacarpal cortical bone mass was measured in 507 healthy Japanese men aged 40–95 years, using a microdensitometer to determine age-related changes in cortical bone in these middle-aged and elderly men. Total bone mass showed a significant negative correlation with age (r = −0.281; P < 0.0001). While bone width showed no significant correlation with age, bone marrow width showed a significant positive correlation (r = 0.210; P < 0.0001), and cortical bone width and cortical bone density showed a significant negative correlation with age (r = −0.265; P < 0.0001; r = −0.268; P < 0.0001, respectively). On the other hand, cortical bone width and cortical bone density showed a significant positive correlation with total bone mass (r = 0.814; P < 0.0001; r = 0.474, P < 0.0001, respectively). These findings suggest that cortical bone mass decreases significantly with aging in middle-aged and elderly men, perhaps as a result of two factors — decreased cortical bone width, ie, cortical bone thinning due to bone loss at the endosteal side of the cortex, and decreased cortical bone density due to progression of intracortical porosity. Cortical bone thinning may influence age-related cortical bone loss more than decreasing cortical bone density.

Age-related changes in cortical bone in women: Metacarpal bone mass measurement study

The mechanism of age-related cortical bone loss was investigated in 229 Japanese women, 41–94 years of age, by metacarpal bone mass measurement. While no significant correlation was found between bone width and age, a significant increase in bone marrow width, and significant decreases in cortical bone density and total bone mass were observed in association with aging (P < 0.0001). There was a significant negative correlation between total bone mass and bone marrow width (r = −0.239; P < 0.0005), and significant positive correlations between both total bone mass and cortical bone density (r = 0.539; P < 0.0001) and cortical bone width (r = 0.839; P < 0.0001). The findings suggested that age-related cortical bone loss in middle-aged and elderly women resulted from two different factors; a decrease in cortical bone density caused by progression of intracortical porosity, and a decrease in cortical bone width as a result of bone loss on the endosteal surface. The latter had a greater influence on an age-related cortical bone loss than the former.

Bias and agreement for radiogrammetric estimates of cortical bone geometry.

Radiogrammetry of the second metacarpal assumes a circular or elliptical model, which does not conform to reality. This study assesses the degree of bias and limits of agreement (error) resulting from deviations from these assumed models for estimates of bone mass and strength. Forty-six left metacarpals were radiographed in orthogonal posteroanterior and mediolateral views for calculation of algebraic estimations of area and bending moments of area. The bones were then sectioned at midshaft and digitized for determination of actual values of these properties. Bias was determined as the mean difference between methods, and error as +/-2 standard deviation. Radiogrammetric methods significantly (P < 0.05) overestimate actual values for measures of cortical area and bending strength. Elliptical models are less biased and prone to smaller ranges of error than are uniplanar circular models. Radiogrammetric estimation of metacarpal bone mass is subject to considerable method error arising from use of an overly simplistic circular model for its midshaft geometry.

Metacarpal bone mass in systemic lupus erythematosus.

We report the prevalence of metacarpal cortical thinning in systemic lupus erythematosus (SLE). Fifty-eight ambulant female patients attending a lupus clinic (mean age 32.4 years), were found to have significant thinning of metacarpal cortices (p < 0.05) when compared with 63 normal females (mean age 34.1 years). However, metacarpal bone mass was within the normal range. Measurements were made at 6 metacarpals of the 2 hands using a computer-aided technique (digitized radiogrammetry). Femoral cortical width and Singh index at the left femur, as well as the vertebral index at L3 were also recorded. The trabecular indices were in the range of normality, but the SLE group had more patients in the immediately pre-osteopenic range. Metacarpal bone loss was not related to disease duration or corticosteroid therapy. The prevalence of osteopenia in SLE is probably underestimated and the pathogenesis is likely to be multifactorial.

Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty‐year followup of incident cases

We examined the prospective relationship between metacarpal bone mass and osteoarthritis (OA) of the hand, using incidence data from the historical cohort in the Tecumseh Community Health Study (Tecumseh, MI). Women were examined for radiographic evidence of OA and for bone mass twice, 20-23 years apart (1962-1965 and 1985; 683 subjects with an age range of 55-74 in 1985). Two measures of OA were evaluated: the highest score assigned to any of the 32 wrist/hand joints, and the sum of scores for all wrist/hand joints. After adjustment for age, women who were classified as having OA (by either measure of OA) in 1985 were more likely to have more cortical area at baseline, which indicates greater bone mass. Women who developed OA in the 23-year period were more likely to experience a significantly greater widening of the medullary cavity over time, an indicator of increased bone resorption. Women with increasing levels of OA involvement also had an increased likelihood of greater cortical area loss. We conclude that women who later developed OA were more likely to have higher baseline bone mass than women who did not develop OA, but these women also had a greater likelihood of bone loss over time.

INCREASED METACARPAL BONE MASS FOLLOWING 18 MONTHS OF SLOW-ACTING ANTIRHEUMATIC DRUGS FOR RHEUMATOID ARTHRITIS

Osteoporosis in RA is mediated by numerous inflammatory substances. This study was undertaken to see if SAARD could modify the rate of metacarpal bone loss in RA. Combined cortical thickness (CCT) measured at the midshaft of the right second metacarpal was used to calculate bone mass (CA%) using a digitizer. Eighty-one subjects were studied, all of whom had at least three sets of hand X-rays, the last of which was approximately 18 months following initiation of SAARD therapy. There were 12 males and 69 females. The mean age at time of starting therapy was 51 (SD 12) years while the mean duration of disease at the time was 7.6 (SD 8) years. The mean time to referral for SAARD from the general clinic was 2.5 (SD 3) years. The percentage fall in bone mass prior to therapy was 2.51%/day compared to a gain of 0.6%/day after therapy (P less than 0.05). Forty-nine patients were aged over 50 years while 32 were 50 years or younger at the time of study. Comparison showed that in the pretreatment period, the rate of change in CCT and CA% was not significantly dependent age (P less than 0.1). During that therapy, the rate of change in CCT and CA% significantly different in the two age groups. Patients aged over 50 years continued to lose bone, but at a slower rate (P less than 0.05). Patients aged 50 years or less either stopped losing or gained metacarpal bone mass during the study period (P less than 0.005). The time to referral for SAARD and disease duration (comparable in the two age groups) did not have a significant effect on changes in CA% during therapy. Change in bone mass could be predicted by change in disease activity. We conclude that SAARD have a significant sparing effect on metacarpal osteoporosis in RA. This positive effect is masked by the overwhelming influence of age (and menopause) and could be missed. Metacarpal osteoporosis seems a pathophysiologically more useful measure of radiological change in RA than erosions or joint space narrowing.

Osteoporosis screening--radiogrammetry revisited.

Radiogrammetry remains a convenient method of bone mass measurement. It is the only objective means of quantifying metacarpal osteoporosis (OP) in rheumatoid arthritis (RA). An automated technique using a digitizer (interfaced with an IBM PC) for measurement of combined cortical width (CCW) at the mid-shaft of six metacarpals was evaluated in three groups of individuals under 50 years of age (98 normal controls, 96 RA, 63 SLE). Intra-observer, inter-observer, and inter-institution reproducibility was assessed with a 'phantom' embedded in a rectangular mould of wax. Intra-patient variation was also assessed in RA patients seen on two occasions less than a month apart. Two hundred and fifty-seven subjects were studied. The method was found to be reproducible for a single observer, among five different observers and in two separate institutions. The RA subjects seen on two occasions showed no significant differences in CCW. The technique showed significant differences of CCW in the three groups of premenopausal subjects (controls; RA; SLE) studied (p less than 0.001). The six metacarpal bone mass was calculated in less than 5 min. The technique of digitized radiogrammetry is an improvement on the Vernier caliper technique. The method is useful for epidemiological cross-sectional studies and for evaluation of long-term radiological changes in RA.

Environmental exposure to cadmium and effects on human health. Part 2. Bone and mineral metabolism in inhabitants of the cadmium-polluted Jinzu River basin in Toyama Prefecture

Serum calcium and phosphorus concentrations, alkaline phosphatase activity and the metacarpal bone mass were measured in 85 female inhabitants of the cadmium-polluted Jinzu River basin aged 55-71 years who had various concentrations of β2-microglobulin (β2-m) in urine. The relationship between cadmium-induced renal tubular dysfunction and abnormalities of calcium and phosphorus metabolism was studied.1) Most of the values for serum calcium were within the normal range. However, fractional calcium excretion (FEca) was increased in 81 subjects (95.3%). The correlation coefficient between urinary excretion of β2-m and FEca was significant (r=0.352, p<0.005).2) Serum phosphorus concentration averaged 3.16±0.48ml/dl and the values found in 28 subjects (32.9%) were below the normal lower limit (3.0mg/dl). There was a significant correlation between serum phosphorus level and TmP/GFR (r=0.797, p<0.001). These observations show that hypophosphatemia is due to excessive renal phosphate excretion.3) Serum alkaline phosphatase activity was definitely elevated in 29 subjects (34.1%). A significant positive correlation of alkaline phosphatase activity and urinary β2-m level was present (r=0.346, p<0.005).4) The metacarpal index (MCI) and ΣGS/D of the second right metacarpal bone were measured by the quantitative microdensitometric method. A significant negative correlation of the urinary β2-m level with MCI and ΣGS/D was present (p<0.01). This result suggested that the degree of renal tubular dysfunction was related to the bone mass.5) This study showed that the inhabitants with severe renal tubular dysfunction had hypophosphatemia due to excessive renal phosphate excretion, increased urinary excretion of calcium, elevated activity of serum alkaline phosphatase and decreased bone mass. We proposed that these cases be diagnosed as latent renal tubular osteomalacia.

Bone mass in patients with rheumatoid arthritis.

Bone loss was evaluated in 118 patients with rheumatoid arthritis by measurement of the total width and marrow cavity of the second metacarpal bone. Both in men and women a significant increase in width of the medullary cavity could be demonstrated, probably due to bone loss at the endosteal surface. Although a certain increase in the total width of the second metacarpal bone took place in men but not in women, combined cortical thickness and metacarpal bone mass decreased significantly. There was no significant difference in the values in patients on gold treatment and in patients without systemic treatment, while patients treated with steroids demonstrated a significantly greater loss of endosteal bone compared to the other two groups. Some correlation was found between the severity of joint involvement and the measured loss of cortical bone. In summary, the study shows that bone loss takes place in patients with rheumatoid arthritis, being most pronounced in steroid-treated patients, in postmenopausal women, and in patients with more severe joint involvement.

Assessment of bone mineral content and bone mass by non-invasive radiologic methods.

Methods for quantitative determination of bone mineral and bone mass in normal subjects and in patients with metabolic bone disorders can be measured by the Compton scattering technique, the neutron activation analysis, by measurement of metacarpal bone mass, by single and dual photon absorptiometry, and by quantitative computed tomography. Measurement on metacarpal bone (radiogrammetry) seems to be able to distinguish between resorption and/or new bone formation at the periosteal and/or endosteal surface. The intraindividual observer variation on combined cortical thickness (D-d), cortical area (D2-d2), metacarpal bone mass (D2-d2)/D2-varies from 0.7 to 2.5 per cent and the interindividual observer variation from 1.0 to 5.8 per cent. Single photon absorptiometry measures bone mineral content in the forearm with great precision. The reproducibility using repeated measurements and automatic selection of the measuring area is about one per cent and can be used to follow changes in mineral content with time in patients with metabolic bone diseases. The dual photon absorptiometry may be used for measurements of bone mineral content in lumbar spine, in the femoral neck and measurement of total body calcium with an accuracy of less than 6 per cent and a precision below 3 per cent. Quantitative computed tomography has the ability to measure trabecular and cortical bone both centrally and peripherally. Using CT scanning, scanner related changes with time (day-to-day variation +/- 4%), patient repositioning (less than 1.5%), and fat concentration (residual uncertainty of approximately 1/6 of the biologic variation) are important factors influencing the accuracy and reproducibility of the values of the measured bone mineral content.(ABSTRACT TRUNCATED AT 250 WORDS)

Amount of bone and bone remodelling in normal subjects and in patients with chronic renal failure.

Quantitative radiologic measurements of the second left metacarpal bone were performed on 63 normal men and 71 normal women, 105 patients with non-dialyzed chronic renal failure and on 32 chronic hemodialyzed men and women. For prospective analysis 42 non-dialyzed patients and 31 patients on chronic hemodialysis were available. Measurements of the total width, medullary cavity and combined cortical thickness at the midshaft of the metacarpal bone were made on postero-anterior hand radiographs with a readout of 0.1 mm using a direct reading needle-tipped calliper. Hereafter the cortical area and metacarpal bone mass were calculated. Mean values of the various parameters in the patient groups were compared with mean values of age-matched normal controls. For the prospective analysis the calculated, yearly change of the various parameters during the observation period were compared with the yearly change in normal persons, being estimated by regression analysis between age and radiologic values. Measurements of the amount of bone in normals and in patients with chronic renal failure were reliable, the intraobserver variation coefficient varying from 0.7 to 2.5 per cent and the interobserver variation coefficient from 1.0 to 5.8 per cent. Changes in thickness of the soft tissue of the hand only slightly affected the values, a change of 10 mm resulted in a change of one per cent of the measured and calculated values. Metacarpal bone mass was significantly reduced in normal men and women older than 50 years of age compared with younger persons.(ABSTRACT TRUNCATED AT 250 WORDS)

Metacarpal bone mass and upper extremity strength in 18-year-old boys

Metacarpal bone mass and upper extremity strength in 18-year-old boys