Measurement of bone mineral content (BMC) of the lumbar spine, II. Correlation between forearm BMC and lumbar spine BMC

Krølner, B.; Nielsen, S. Pors; Lund, B.; Sørensen, Ole; Uhrenholdt, A

doi:10.1080/00365518009091979

Cited by 39 publications

(2 citation statements)

References 10 publications

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“…Although the radial density was moderately correlated with spinal density in both patients and normal subjects, the prediction error was too large (>25% at the 95% confidence interval) to allow even gross quantitative assessment of the spine. Previous studies have reported similar findings (6)(7)(8)(9)22,23). Conceivably, appendicular sites containing more trabecular bone could be expected to give better prediction, but this is not the case.…”

Section: Discussionmentioning

confidence: 55%

Radial and spinal bone mineral density in a patient population

Mazess

Barden

Ettinger

1988

Arthritis & Rheumatism

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Density of the radius (by single-photon absorptiometry) and the spine (by dual-photon absorptiometry) was measured in 281 normal young women and in a large heterogenous group of 1,622 consecutive female patients. Both spinal and radial density were useful measurements when performed on patients with medical indications; spine and radius densities in these patients averaged 1620% below those of age-matched controls. However, patients younger than 60 years of age had deficits of spine density that were twice as large as those in the radius, and twice as many of these patients had spinal osteopenia, compared with those with radial osteopenia. After age 70, loss of density in the radius approximated that in the spine and the prevalence of osteopenia was similar at both sites. The poorer sensitivity of the radius measurement reflected the fact that it did not predict spine density. The standard error of the estimate was 0.12 gm/cm2 in normal subjects and 0.15 gm/cm2 in patients. At any given radial density, the spinal density of patients averaged 0.18 gm/cm2 (15-20 % ) below that in normal subjects. Predictions of spinal density from body weight were as accurate as predictions from radial density. Preferential spinal osteopenia occurring without radial osteopenia precluded radial densitometry as a screening method for individuals with osteoporosis before age 60. However, measurement of the radius was more effective than body weight for defining groups at risk, even though the radius did not reliably predict individual spine density. A radius shaft density <0.55 gm/cm2 occurring with a body weight 6 5 kg was associated with a high prevalence of spinal osteopenia.Osteoporosis, or accentuated loss of bone in the axial skeleton, is a common disorder among the elderly that is manifested by fractures of the spine, proximal femur, and proximal humerus (1). Bone mineral content (BMC) is directly proportional to bone strength in these fracture regions (2,3). Bone loss at fracture sites, measured by dual-photon absorptiometry, is associated closely with increased fracture rates at these sites (43). A 10% decrease in bone mineral density (BMD) increases the risk of fracture 2-3-fold. Therefore, the 30-35% decrease in spine density and 45% decrease in femoral density, usually found in patients with fractures, implies a fracture risk that is 20-50 times greater than that in young normal women, and 10-20 times greater than that of age-matched controls.There is relatively poor diagnostic sensitivity for crush fracture using peripheral densitometry compared with axial densitometry (4,6). Pocock et a1 (7) showed that spinal or femoral osteopenia (>20% loss of BMD) could be detected with a sensitivity of 85% (1 5% undetected) from forearm densitometry only when the false-positive rate was higher than 60% (~4 0 % specificity). Presumably, this was due to the poor correlation between axial and appendicular bone

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Section: Discussionmentioning

confidence: 55%

Radial and spinal bone mineral density in a patient population

Mazess

Barden

Ettinger

1988

Arthritis & Rheumatism

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“…Bone mineral measurements in healthy (human) individuals have shown that there is not a significant difference between bone mineral in the left and the right leg, when identical sites of measurement in the lower extremities are compared (9,10). For more than the past decade dual photon absorptiometry (DPA) has been used to measure bone mineral content (BMC) and bone mineral density (BMD) at various measuring sites throughout the human skeleton (7,(11)(12)(13). In contrast to other methods to estimate bone mineral in vitro, the method using DPA is non-invasive, with a high accuracy and a precision error between 2-3% (14).…”

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confidence: 99%

Measurement of Bone Mineral Content to Facilitate an Objective Evalution of Limp Function in the Dog

Svalastoga¹,

Mm²,

Wenck³

et al. 1994

Vet Comp Orthop Traumatol

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SummaryThe aim of this study was to evaluate the feasibility of using measurements of bone mineral content (BMC) and bone mineral density (BMD) by dual photon absorptiometry (DPA; Gadolinium-153), as an objective measure of limb functional status in the dog. The in vitro accuracy error expressed as the standard error of the estimate (SEE) for BMC and BMD measurements was 3.2% and 1.1% respectively, and the precision in vivo for measurements of BMC and BMD in the distal diaphysis of the tibia and fibula was 2.1% and 1.9% respectively. A significant difference in bone mineral between right and left leg was not found in normal dogs, and in these dogs the average percentage intra-individual difference, between bone mineral in the legs with the highest bone density and the legs with the lowest density, was 2.2% and 3.7% for BMC and BMD respectively. However the BMC and BMD in eight clinical cases of unilateral lameness were significantly decreased in the affected legs, when compared to the healthy contralateral legs, by 20.4% (P = 0.01) and 18.3% (P = 0.01)respectively. Measurements of BMC and BMD by DP A in weight-bearing extremities in the dog showed that bone mineral is highly sensitive to decreased loading of the extremity. This method might well be used not only as an objective measure of limb activity, but also for measurement of prospective changes in bone mineral, following treatment of musculoskeletal diseases and injuries.The feasibility of using bone mineral measurements by dual photon absorptiometry, as an objective measure of limb functional status in the dog, was evaluated. Precision and accuracy were calculated from in vitro and in vivo studies. In eight cases of unilateral lameness bone mineral was significantly decreased (20%) in the affected legs when compared to the healthy contralateral legs.

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Limitations of forearm bone densitometry as an index of vertebral or femoral neck osteopenia

Pocock

Eisman

Yeates

et al. 1986

Journal of Bone and Mineral Research

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Osteoporosis of the spine and femoral neck is a major problem in aging populations, but detection prior to a fracture remains a challenge. Forearm bone mineral content has been advocated as a useful screening test in this situation. We have examined the correlation between distal forearm bone mineral content, by single photon absorptiometry, and lumbar vertebral and femoral neck bone mineral density, by dual photon absorptiometry. Eighty women aged 20 to 76 years were studied and significant correlations (p less than .001) were found between the measurements on the forearm and at the two axial sites (r = 0.66 and 0.69, respectively). However, forearm bone mineral content was an unreliable predictor of axial bone mineral density. For prediction of lumbar spine osteopenia with a sensitivity of 88%, the false positive rate was 91%. Conversely, to achieve a specificity of 82%, the false negative rate was 65%. Similarly, for prediction of femoral neck osteopenia at a sensitivity of 92%, the false positive rate was 87%, and at a specificity of 90%, the false negative rate was 33%. These data demonstrate that forearm bone densitometry cannot be used as a screening procedure for osteopenia of the lumbar spine or femoral neck.

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Measurement of bone mineral content (BMC) of the lumbar spine, II. Correlation between forearm BMC and lumbar spine BMC

Cited by 39 publications

References 10 publications

Radial and spinal bone mineral density in a patient population

Radial and spinal bone mineral density in a patient population

Measurement of Bone Mineral Content to Facilitate an Objective Evalution of Limp Function in the Dog

Limitations of forearm bone densitometry as an index of vertebral or femoral neck osteopenia

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