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

Ye, ChunXiao; Guo, YingBin; Zheng, YouHui; Wu, ZhenBin; Chen, KaiYu; Xiao, LiangXiu; Chen, ZhiMing

doi:10.1016/j.injury.2020.08.018

Cited by 8 publications

(5 citation statements)

References 45 publications

(35 reference statements)

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“…For example, Long et al showed in 2015 that the normalized cortical bone thickness (NCBT) estimated from the patient's hip DXA, discriminated hip fracture [50]. Likewise, Ye et al demonstrated in 2020 that estimates of distal radius cortical thickness (DRCT), obtained from anteroposterior radiographs, can predict osteoporosis [51]. Likewise, cortical bone porosity is also known to be associated with fragility fractures [52].…”

Section: Plos Onementioning

confidence: 99%

Bi-Directional Axial Transmission measurements applied in a clinical environment

Minonzio

Ramiandrisoa²,

Schneider

et al. 2022

PLoS ONE

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Accurate measurement of cortical bone parameters may improve fracture risk assessment and help clinicians on the best treatment strategy. Patients at risk of fracture are currently detected using the current X-Ray gold standard DXA (Dual XRay Absorptiometry). Different alternatives, such as 3D X-Rays, Magnetic Resonance Imaging or Quantitative Ultrasound (QUS) devices, have been proposed, the latter having advantages of being portable and sensitive to mechanical and geometrical properties. The objective of this cross-sectional study was to evaluate the performance of a Bi-Directional Axial Transmission (BDAT) device used by trained operators in a clinical environment with older subjects. The device, positioned at one-third distal radius, provides two velocities: VFAS (first arriving signal) and VA0 (first anti-symmetrical guided mode). Moreover, two parameters are obtained from an inverse approach: Ct.Th (cortical thickness) and Ct.Po (cortical porosity), along with their ratio Ct.Po/Ct.Th. The areal bone mineral density (aBMD) was obtained using DXA at the femur and spine. One hundred and six patients (81 women, 25 men) from Marien Hospital and St. Anna Hospital (Herne, Germany) were included in this study. Age ranged from 41 to 95 years, while body mass index (BMI) ranged from 16 to 47 kg.m−2. Three groups were considered: 79 non-fractured patients (NF, 75±13years), 27 with non-traumatic fractures (F, 80±9years) including 14 patients with non-vertebral fractures (NVF, 84±7years). Weak to moderate significant Spearman correlations (R ranging from 0.23 to 0.53, p < 0.05) were found between ultrasound parameters and age, BMI. Using multivariate Partial Least Square discrimination analyses with Leave-One-Out Cross-Validation (PLS-LOOCV), we found the combination of VFAS and the ratio Ct.Po/Ct.Th to be predictive for all non traumatic fractures (F) with the odds ratio (OR) equals to 2.5 [1.6-3.4] and the area under the ROC curve (AUC) equal to 0.63 [0.62-0.65]. For the group NVF, combination of four parameters VA0. Ct.Th, Ct.Po and Ct.Po/Ct.Po, along with age provides a discrimination model with OR and AUC equals to 7.5 [6.0-9.1] and 0.75 [0.73-0.76]. When restricted to a smaller population (87 patients) common to both BDAT and DXA, BDAT ORs and AUCs are comparable or slightly higher to values obtained with DXA. The fracture risk assessment by BDAT method in older patients, in a clinical setting, suggests the benefit of the affordable and transportable device for the routine use.

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Section: Plos Onementioning

confidence: 99%

Bi-Directional Axial Transmission measurements applied in a clinical environment

Minonzio

Ramiandrisoa²,

Schneider

et al. 2022

PLoS ONE

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“…Selda Aksoy 1 , Mehmet Ali Güner 1 , ‹nanç Güvenç 2 , Sedat Bilge 3 , Onur Tezel 3 the intraosseous route is inadequate. Although the cortical bone thickness of the distal radius is well known, [11][12][13] the safety of the region for intraosseous procedures has not been confirmed.…”

Section: Radioanatomical Examination Of the Dorsal Tubercle And Surrounding Regions For Intraosseous Infusionsmentioning

confidence: 99%

Radioanatomical examination of the dorsal tubercle and surrounding regions for intraosseous infusions

Aksoy¹,

Güner²,

Güvenç³

et al. 2020

Anatomy

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Objectives: The aim of the study was to determine the soft tissue thickness overlying the dorsal tubercle and the relationship with adjacent anatomical structures in the distal radius for using this area as an alternative intraosseous route. Methods: Contrast-enhanced MR images of 56 adult patients (28 females, 28 males) without any wrist pathology were evaluated. The shape of dorsal tubercle and its relations with neighboring tendons and vessels with a diameter larger than 2 mm was identified on the axial T1-weighted sections. The soft tissue thickness above the most protruding point of the dorsal tubercle, the distance of the dorsal tubercle to closest tendon on the radial and ulnar sides, as well as its distance to the bone edges on the ulnar and radial sides, and the cortical bone thickness of the radius was evaluated. Results: The dorsal tubercle had sharp edges in 40 cases (71.4%), blunt in 12 cases (21.4%), and hump in 4 (%7.1) cases. Branches of dorsal venous plexus were found on its surface in 11 cases, extensor pollicis longus tendon only was found superficial to the dorsal tubercle in 7 cases while both extensor pollicis longus and dorsal venous branches were found in 2 cases. Conclusion: Dorsal tubercle of the distal radius can be considered as an important alternative route for IO infusions since it can be easily accessed without having a risk of injury to important structures, and can provide effective flow.

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“…The current clinical gold standard to determine osteoporosis-related bone fragility is dual-energy X-ray absorptiometry (DXA) measurement of BMD [ 15 ]. However, DXA is not routinely used as an investigation in asymptomatic patients, which is why an osteoporotic fracture can be the first sign of degenerative bone loss [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies of cortical thickness on anteroposterior (AP) radiographs have demonstrated a correlation with BMD measured by DXA [ 15 , 18 , 19 ]. He et al [ 18 ] were the first to develop a measurement technique to assess mean cortical bone thickness (CBTavg) of the distal femur on AP radiographs.…”

Section: Introductionmentioning

confidence: 99%

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

Huppke,

Fahlbusch,

Frosch

et al. 2023

Arch Orthop Trauma Surg

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Aim Distal femur fractures (DFF) are rare, but associated with high complication rates and mortality, particularly in patients with osteoporosis. To improve preoperative assessment, we analyzed if cortical bone thickness on CT and AP radiographs is associated with clinical parameters of bone quality. Methods Retrospective single-center study of adult patients presenting at a level-one trauma center, with a DFF between 2011 and 2020. Clinical parameters for bone quality, such as age, sex, body mass index (BMI), energy impact level of trauma, and known history of osteoporosis, were assessed. Mean cortical bone thickness (CBTavg) on AP radiograph was determined using a previously published method. Cortical thickness on CT scan was measured at 8 and 14 cm proximal to the articular surface of the lateral condyle. Results 71 patients (46 females) between 20 and 100 years were included in the study. Cortical thickness determined by CT correlated significantly with CBTavg measurements on AP radiograph (Spearman r = 0.62 to 0.80; p < 0.001). Cortical thickness was inversely correlated with age (Spearman r = − 0.341 to − 0.466; p < 0.001) and significantly associated with trauma impact level and history of osteoporosis (p = < 0.001). The CT-based values showed a stronger correlation with the clinical parameters than those determined by AP X-ray. Conclusion Our results showed that cortical thickness of the distal femur correlates with clinical parameters of bone quality and is therefore an excellent tool for assessing what surgical care should be provided. Interestingly, our findings indicate that cortical thickness on CT is more strongly correlated with clinical data than AP radiograph measurements.

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

Cited by 8 publications

References 45 publications

Bi-Directional Axial Transmission measurements applied in a clinical environment

Bi-Directional Axial Transmission measurements applied in a clinical environment

Radioanatomical examination of the dorsal tubercle and surrounding regions for intraosseous infusions

Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians

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