Bone Abstracts

There is a growing evidence of the association between HIV infection and fracture risk. Independently of its cause (antiretroviral therapy (ART) or HIV), what remains most important is a prompt diagnosis. Although densitometry is the gold standard, sometimes this technique is not as accurate as necessary in clinical practice. A new validated tool for early and more accurate diagnosis is presented.MethodsIn a HIV group of patients, ...

Bone mineral density (BMD) as measured by quantitative computed tomography (QCT) is biased by the variable marrow composition since marrow fat reduces the apparent BMD. We developed a marrow densitometry (MD) method that identifies subvolumes in the vertebrae that consist of bone marrow only (bone voids) and determines their average mineral equivalent density values. The method was developed for use with in vivo high resolution QCT (HR-QCT). HR-QCT still has limited s...

Diabetes is associated with increased risk of fracture, although type 2 diabetes mellitus (T2DM) is characterized by normal bone mineral density (BMD). Thus, diabetes may be associated with a reduction of bone strength that is not reflected in the measurement of BMD. It is very problematic to measure the bone quality in daily practice. Trabecular bone score (TBS) iNsight® is one of these tools, now available for routine clinical practice, that allows for refinement of mic...

Aging is associated with a loss of systemic bone mass and an increased risk of especially the spine and hip. Therefore bone loss of teeth and ridge resorption can occur in the mouth. However, results of several studies investing association between systemic bone density and oral health have varied. In this study, we investigated the relationship between osteoporosis and dental caries with the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2008&#1...

Introduction: The blood loss sustained during hip fracture repair can be significant and is associated with a high-risk of post-operative anaemia. Anaemia may exacerbate chronic cardiac and pulmonary conditions suffered by this aging population leading to increased morbidity and mortality.Objective: To assess the prevalence and severity of anaemia throughout hospital admission in patients admitted with a fractured neck of femur.Met...

Sacral insufficiency fracture is known as a common cause of lumbosacral pain developed without evident trauma in patients with osteoporotic spinal compression fracture. The purpose of study was to investigate the incidence and predisposing factors of sacral insufficiency fracture accompanied by osteoporotic spinal compression fracture.We carried out a retrospective study of 949 patients who were measured bone mineral densitometry (BMD) and showed osteopo...

Glucocorticoid (GC)-induced osteoporosis (GIO) occurs in patients undergoing therapeutic intervention for inflammatory disorders such as rheumatoid arthritis and lupus. The effect of long-term GC administration on bone turnover was investigated in two frequently used mouse strains; C57BL/6 and CD1 in order to assess the influence of genetic background.GIO was induced in 12 weeks old female C57BL/6 and CD1 mice by s.c. insertion of long-term (60 days) rel...

Fracture outpatient (FO) clinics aim to identify individuals at high fracture risk. Identification of individuals at high fracture risk has been improved since the introduction of vertebral fracture assessment (VFA). Unfortunately, participation rates in FO clinics are often low.The aim of this study is to i) assess the contributory value of VFA in addition to BMD measurements in identifying individuals with high fracture risk; ii) assess characteristics...

Background: The prevalent vertebral fracture (VF) is a risk factor for future VF, which can be decreased with drug therapy. However, most VFs are not recognized clinically. VFA by DXA and spine X-ray can be performed to detect these prevalent VFs.Objectives: This study aimed to estimate the costs, effectiveness, and radiation exposure of VF diagnostic strategies.Methods: Markov model over a 10-year period was used to calculate the ...

Introduction: The first clinical applications of FE-strength estimates to classify osteoporotic fractures showed inhomogeneous results. We developed a FE model that correlated well with femur strength in-vitro (R2=0.9, 14 femurs). This work aims to verify if our model can classify osteoporotic fractures in three case-control studies: a retrospective and a prospective study on proximal femur fracture, and a retrospective study on prevalent ...

Background: Patients with differentiated thyroid cancer (DTC) are treated with L-thyroxine (L-T4) in relatively hight doses to suppress endogenous TSH levels. Very long-term effect of thyroid hormones supplementation on bone are controversial.Objetive: To study the possible negative effects on bone mineral density (BMD) and bone markers in DTC patients followed in our center.Methods: A 46 po...

The objective of this investigation was to compare bone mineral density (BMD) attained from dual-energy X-ray DXA with speed of sound (SOS) data attained from a Beam-Med Omnisense multisite quantitative ultrasound (mQUS) in a large sample of randomly-selected community-based individuals from the Canadian Multicentre Osteoporosis Study (CaMOS). A total of 1177 men and 2949 women were assessed with mQUS at the distal radius, tibia, and phalanx sites as part of the Canadian Multi...

Bone resorption and formation occur in a tightly regulated fashion reflecting the coupled activities of osteoclasts and osteoblasts. Several pathological conditions perturb this balance, including osteoporosis and skeletal metastases. In the case of metastases, the uncoupling of resorption and formation activities contributes to disseminated tumor cells homing to the bone and to tumor growth within the bone in highly localized regions. Therefore, a site-specific marker of bone...

Objective: According to National Osteoporosis Foundation (NOF) guidelines, treatment is recommended for osteoporotic patients and patients with osteopenia and high fracture probability (FRAX with BMD over 3% for hip and/or over 20% for other fractures). In this study, a pocket size pulse-echo (PE) ultrasound (US) device and FRAX with BMI is used in treatment pathway analysis and compared to NOF guidelines.Materials and methods: Elderly Caucasian woman (<...

Objective: Currently, majority of the osteoporotic patients are not diagnosed i) a new ultrasound based device (Bindex) has been recently introduced for osteoporosis (OP) screening and diagnostics at primary healthcare ii) Bindex measures cortical thickness and determines parameter called density index (DI). Thresholds for DI in OP assessment have been determined in Finnish-Caucasian (F-C) population (n=448) along the International Society of Clinical Densitometry (IS...

Objective: To evaluate the changes of health-related quality of life (HRQoL) 36 months after fracture in patients from Lithuania following vertebral or forearm fractures.Material and methods: Patients aged 50 years and older, with low energy trauma clinical vertebral fracture (VFx) or distal forearm fracture (FFx), enrolled and observed for 18 months in the International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS) in Lithuania, w...

In the recent years, worldwide the FRAX algorithm is used more extensively to estimate the risk of fragility fractures. Since 2009, the Ukrainian Scientific Medical Centre on Osteoporosis has been extensively using the FRAX algorithm to estimate the fragility fracture risk.The aim of the study was to establish the normative data for the Austrian model of FRAX algorithm. We examined 3405 women aged 40–89. For the statistical analysis of results the S...

BMD alone is not sufficient to predict the fracture risk for an individual. Others parameters, such as microarchitecture play a key role in bone fragility. Several cross-sectional studies have shown the ability of TBS to discriminate fractured from healthy subjects in European populations. The aim of our study is to assess the ability of TBS, evaluated at the lumbar spine, to discriminate subjects with and without fracture in a large white US population....

This investigation sought to assess the relationship between physical activity (PA) and estimated bone stiffness as assessed by multisite quantitative ultrasound (mQUS) in a large cohort. A total of 1177 men and 2949 women were assessed with mQUS (Beam-Med Omnisense quantitative ultrasound; Isreal) at the distal radius, tibia, and phalanx sites as part of the Canadian Multicentre Osteoporosis Study (clinical sites included Saskatoon, Calgary, Hamilton, Quebec City, Halifax and...

Introduction: Kidney dysfunction is common in the elderly and has been proven to have an association with increased hip fracture incidence. Acute dysfunction may also delay surgery. Serum creatinine, a product of metabolised muscle tissue is a marker used to determine changes in renal function.Objective: To assess the renal function of hip fracture patients throughout their hospital stay using serum creatinine as the marker of renal function.<p class...

Background: DXA scan has for many years been gold standard when analyzing areal bone mineral density (aBMD) in osteoporotic patients. Risk of fractures increases as aBMD declines. However, although risk of fracture is highest in patients with osteoporosis, it is well known that the majority of fragility fractures actually occur in patients with osteopenia rather than osteoporosis. As aBMD is a projected two dimensional imaging technique it does not differentiate between cortic...

Objective: The purpose of this study was to determine the impact of age on the ultrastructural, histological, biomechanical, and biochemical changes of bone tissue in rats.Methods: The study included 24 female rats of two age groups: Group A (Young) of 5-month old rats and Group B (Old) of 18-month old rats. Radiomorphometric assessment of the hydroxyapatite was used to investigate the ultrastructure of the alveolar bone tissue. Biomechanical and biochem...

This investigation sought to assess the relationship between vitamin D and calcium intake and estimated bone stiffness as assessed by multisite quantitative ultrasound (mQUS) in a large cohort. A total of 1177 men and 2949 women were assessed with mQUS (Beam-Med Omnisense quantitative ultrasound; Isreal) at the distal radius, tibia, and phalanx sites as part of the Canadian Multicentre Osteoporosis Study (clinical sites included Saskatoon, Calgary, Hamilton, Quebec City, Halif...

New treatment agents against osteoporosis may not only lead to an improved trabecular structure, but can probably also strengthen the cortex. To assess this treatment effects by means of QCT, one has to deal with significant partial volume effects observing this very thin, but compact structure. A new method for cortical thickness estimation has been developed using an analytical deconvolution approach. After estimating the point-spread-function (PSF) of a scanner/kernel combi...

Background and aims: Bone turnover markers (BTMs) are used in clinical practice for assessing patients with osteoporosis and their treatment. In Spain it is necessary to fine-tune the reference intervals, since they were established years ago in a low number of individuals. The aims of this study were to establish robust reference intervals for BTMs in healthy young premenopausal Spanish women and to investigate the factors influencing BTMs.Methods: 185 ...

Objection: We compared T-scores of each femoral neck and trochanteric area in the neck fracture patients (NFP) and intertrochanteric fracture patients (IFP). Our hypothesis is that T-score of neck portion in NFP is lower than T-score of neck portion in IFP, and vice versa. We evaluate how FRAX probability is meaningful and sensitive in hip fracture patients.Meterials and methods: From April, 2003 to September, 2012, 18...

Introduction: Gamma type nails are routinely used for the fixation of intertrochanteric fractures of the proximal femur. QCT at the hip is an advanced method that is increasingly being used to estimate BMD and determine the future fracture risk. Yet, implants cause metal artefacts (MA) in CT images, even at the contralateral side due to the high absorption of metal, which may impair BMD accuracy.Methods: Three human cadavers were scanned first without an...

The study is aimed to evaluate body composition and bone status in adult patients with active juvenile idiopathic arthritis (JIA) untreated with tumor necrosis factor α inhibitors. Adult patients (12 males and 19 females) with JIA and 84 healthy age- and gender- matched controls were enrolled into the study. Body composition and areal bone mineral density (aBMD) at the lumbar spine, proximal femur, femoral neck, distal radius and total body were assessed using dual energy...

A clinical and densitometric study was performed in the group of 62 adults with cerebral palsy (CP) under institutionalized care in the district of Przemyśl (Southern Poland), 12 of whom had the history of 15 radiologically confirmed non-phalangeal limb fractures. The study assessed correlation between the prevalence of fractures and age, body mass, locomotor abilities determined by Gross Motor Function Classification System (GMFCS), presence of epilepsy, antiepileptic dr...

Objective: The postmenopausal women and elderly men have a big burden for osteoporosis related vertebral fracture and the frequency of clinically unrecognized vertebral fracture is known to be increasing. Vertebral Fracture Assessment (VFA) using DXA is a convenient and safe method to patients together with bone density test and is reported to be proper as a screening method to prevent additional vertebral fracture as diagnosing the vertebral fracture with unrecognized symptom...

The aim of this study was to evaluate the trabecular bone score (TBS), bone mineral density (BMD) and body composition in men of various ages.Materials and methods: 300 men aged 40–87 years (mean age – 60.5±0.6 years; mean height – 1.61±0.003 m; mean weight – 84.1±0.9 kg) were examined. The patients were divided into the following age-dependent groups: 40–49 years (n=52), 50–59 years (n=90), ...

The aim of this study was to evaluate the trabecular bone score (TBS), bone mineral density (BMD) and body composition in women of various ages.Materials and methods: 494 women aged 41–89 years (mean age, 63.6±0.4 years; mean height, 1.61±0.003 m; and mean weight, 74.0±0.6 kg) were examined. The patients were divided into the following age-dependent groups: 40–49 years (n=35), 50–59 years (n=130), 60–6...

Objective: To assess the prevalence of co-morbidities in fracture neck of femur patients.Methodology: Study design: Retrospective cohort study.Setting: District General Hospital in United Kingdom.Study subject: a total of 75 patients with fracture neck of femur from 2012 to 2013 were ascertained for any associated co-morbid conditions by case note study.Results: Out of 75 patients, 61 (...

Introduction: The FRAX tool can be used to assess absolute fracture risk, but the majority of treatment decisions are still based on measurements by DEXA. In remote rural Greek areas, after the socioeconomy crisis, access to the nearest DEXA facility became more difficult.Purpose: Role of combined QUS and FRAX in the identification of low risk patients who do not require DEXA applying a FRAX threshold of 4% for the 10-year major osteoporotic fracture pro...

Age is one of the most important factors that influence bone condition. At the age of 40–45 years for women (F) and 50 years for men (M) processes of bone formation and resorption are balanced, then bone resorption predominates.We examined 103 M (20–78 years) and 360 F (20–87 years), residing in the Republic of Karelia. Densitometry was performed for all patients to assess age-related changes in bone mineral density (BMD) at the lumbar spi...

Minodronate has been reported to increase bone mineral density (BMD) and reduce fracture risk. The purpose of this study was to clarify the effect of minodronate on the three-dimensional vertebral microarchitecture in vivo.Minodronate-treated osteoporosis female patients (n=9) and non-treated age-matched historical control (n=5) were retrospectively evaluated. After areal BMD (aBMD) evaluation by DXA, 3rd lumbar spine was scann...

Objective: To assess the prevalence of post-operative medical and surgical complications among fracture neck of femur patients.Method: Study design: retrospective cohort study.Setting: District General Hospital in UK.Study subject: a total of 75 patients with fracture neck of femur from 2012 to 2013 were ascertained for any post-operative complications by case note study.Results: Out of...

Introduction: Although systemic lupus erythematosus (SLE) has traditionally been considered a disease of women, men may also be afected. Male osteoporosis is increasingly recognised. Several studies have reported that mean bone mineral density is significantly reduced in SLE women patients and most of them have low levels of vitamin D. The aim of our study is to analize this situation in men.Objectives: Determine 25-hydroxyvitamin-D (25OHD) serum concent...

The objective of this study was to evaluate the ability of various quantitative ultrasound variables to discriminate osteoporotic female corticosteroid users. Thirty-two women aged between 26 and 79 years who have been receiving corticosteroids equivalent to a minimum of 5 mg daily prednisolone for more than 3 months underwent bone mineral density (BMD) measurements at the lumbar spine, hip, and one-third radius (33% radius) using dual-energy X-ray absorptiometry (DXA). Acoust...

Background: Dual-energy X-ray absorptiometry (DEXA) is the gold standard used for measuring bone mineral density and such readings are currently used to predict osteoporosis and osteoporotic fractures. However, no similar prediction model has been developed to identify the age that a patient will become osteoporotic based on DEXA scanning.Objective: The aim of this study was to develop a mathematical model to determine the TTO based on two or more DEXA s...

Multiple factors of risk have been described to the osteoporosis (OSP) and fractures in people infected by human immunodeficiency virus (HIV). Antiretroviral treatment has changed the vital prognosis of these patients, nevertheless seems that antiretroviral treatments can cause a greater loss of bone mineral density (BMD). Experts support the use of densitometry screening for HIV-infected postmenopausal women and men older than 50 years.Objectives: To ev...

Introduction: The FRAX model is a new method to assess fracture risk and this aspect is important in menopause. The DXA is still the golden standard but the relationship between these two instruments is complex.Aim: We correlate the 10-year absolute fracture risk of hip (10-yH) and major fractures (10-yM) based on FRAX with or without bone mineral density (BMD) with lumbar DXA in menopause women, and we use a statistical model to find out whether the vit...

Background: Bone marrow (BM) adiposity is inversely related to bone mineral density and increases with ageing and menopause. We previously observed that the variation in BM fat fraction was more pronounced in premenopausal women compared to men and postmenopausal women. We hypothesized that the variation in BM fat fraction in premenopausal women is associated with hormonal variations during the menstrual cycle.Objective: To investigate the dynamic change...