High-resolution pQCT analysis at the distal radius and tibia discriminates patients with recent wrist and femoral neck fractures

J Bone Miner Res. 2008 Nov;23(11):1741-50. doi: 10.1359/jbmr.080704.


We depict a fragility bone state in two primitive osteoporosis populations using 3D high-resolution peripheral in vivo QCT (HR-pQCT). Postmenopausal women (C, controls, n = 54; WF, wrist, n = 50; HF, hip, n = 62 recent fractured patients) were analyzed for lumbar and hip DXA areal BMD (aBMD), cancellous and cortical volumetric BMD (vBMD), and microstructural and geometric parameters on tibia and radius by HR-pQCT. Principal component analysis (PCA) allowed extracting factors that best represent bone variables. Comparison between groups was made by analysis of covariance (ANCOVA). Two factors (>80% of the entire variability) are extracted by PCA: at the radius, the first is a combination of trabecular parameters and the second of cortical parameters. At the tibia, we found the reverse. Femoral neck aBMD is decreased in WF (8.6%) and in HF (18%) groups (no lumbar difference). WF showed a approximately 20% reduction in radius trabecular vBMD and number. Radius cortical vBMD and thickness decrease by 6% and 14%, respectively. At the tibia, only the cortical compartment is affected, with approximately 20% reduction in bone area, thickness, and section modulus and 6% reduction in vBMD. HF showed same radius trabecular alterations than WF, but radius cortical parameters are more severely affected than WF with reduced bone area (25%), thickness (28.5%), and vBMD (11%). At the tibia, trabecular vBMD and number decrease by 26% and 17.5%, respectively. Tibia cortical bone area, thickness, and section modulus showed a >30% decrease, whereas vBMD reduction reached 13%. Geometry parameters at the tibia displayed the greatest differences between healthy and fractured patients and between wrist and hip fractures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / pathology
  • Body Weight
  • Bone Density
  • Case-Control Studies
  • Female
  • Femoral Neck Fractures / diagnostic imaging*
  • Femoral Neck Fractures / physiopathology
  • Hip Fractures / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Radius / diagnostic imaging*
  • Radius / physiopathology
  • Tibia / diagnostic imaging*
  • Tibia / physiopathology
  • Tomography, X-Ray Computed*
  • Wrist Injuries / diagnostic imaging*
  • Wrist Injuries / physiopathology