BoneKEy Reports | BoneKEy Watch
DXR-derived cortical porosity predicts fragility fractures
DOI:10.1038/bonekey.2013.204
Although reduced bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DXA), is a risk factor for fragility fractures, many patients have only slightly lower BMD than healthy controls. This case–control study by Dhainaut et al. explored several markers determined by digital X-ray radiogrammetry (DXR) for their predictive potential.
The study included 123 women aged over 50 years with a fragility fracture of the distal radius and 170 healthy controls. In addition to a DXA scan of the femoral neck, all women were given DXR to measure metacarpal cortical bone density (DXR-BMD) and to estimate cortical bone porosity (DXR-porosity), bone width (DXR-W) and bone thickness (DXR-CT). In the patient group, DXR was performed in the hand of the same arm as the distal radius fracture.
The two groups showed significant differences in body mass index, weight, DXA-derived BMD at the femoral neck and in several DXR-derived scores, including DXR-BMD, DXR-porosity and DXR-CT of the hand. No difference was seen in DXR-W scores. In a simple age-adjusted regression analysis, distal radius fracture was significantly associated with DXR-BMD, DXR-CT and DXR-porosity, as well as DXA-derived BMD at the femoral neck and BMI. However, after adjustment for 14 other variables (e.g. smoking, osteoporosis treatment, history of falls and exercise), only DXR-porosity remained significant (adjusted OR 1.415, 95% CI 1.194–1.677).
Editor’s comment: DXR-derived cortical porosity is associated with fracture at the distal radius and might be a sensitive marker for skeletal fragility.
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