Cortical and Trabecular Bone Analysis of Patients With High Bone Mass From the Barcelona Osteoporosis Cohort Using 3-Dimensional Dual-Energy X-ray Absorptiometry: A Case-Control Study

J Clin Densitom. Oct-Dec 2018;21(4):480-484. doi: 10.1016/j.jocd.2017.05.012. Epub 2017 Jun 22.


High bone mass (HBM), a rare phenotype, can be detected by dual-energy X-ray absorptiometry (DXA) scanning. Measurements with peripheral quantitative computed tomography at the tibia have found increased trabecular bone mineral density and changes in cortical bone density and structure, all of which lead to increased bone strength. However, no studies on cortical and trabecular bone have been performed at the femur. The recently developed 3-dimensional (3D)-DXA software algorithm quantifies the trabecular and cortical volumetric bone mineral density (vBMD) and the anatomical distribution of cortical thickness using routine hip DXA scans. We analyzed the femurs of 15 women with HBM and 15 controls from the Barcelona Osteoporosis (BARCOS) cohort using the 3D-DXA technique. The mean vBMD of proximal femur was 29.7% higher in HBM cases than in controls for the integral bone, 41.3% higher for the trabecular bone, and 7.3% higher for the cortical bone (p < 0.001). No differences in bone size were detected between cases and controls. Patients with HBM had a thicker cortex and higher trabecular and cortical vBMDs, as measured by 3D-DXA at the femur and compared to controls; bone size was similar in both groups. To the best of our knowledge, this is the first description of trabecular and cortical characteristics of the hip in patients with HBM.

Keywords: 3D-DXA; DXA; bone mineral density; high bone mass.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon / methods*
  • Aged
  • Algorithms
  • Bone Density* / physiology
  • Cancellous Bone / diagnostic imaging*
  • Cancellous Bone / physiology
  • Case-Control Studies
  • Cortical Bone / diagnostic imaging*
  • Cortical Bone / physiology
  • Female
  • Femur / diagnostic imaging*
  • Femur / physiology
  • Humans
  • Imaging, Three-Dimensional
  • Middle Aged