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Tibial cortical thickness: A dependable tool for assessing osteoporosis in the absence of dual energy X-ray absorptiopmetry.

Sadat-Ali M, Elshaboury E, Al-Omran AS, Azam MQ, Syed A, Gullenpet AH - Int J Appl Basic Med Res (2015 Jan-Apr)

Bottom Line: Inter cortical distance (ICD) was measured and compared in both groups.There was a significant association between the T score and the TCT and age.We conclude that if TCT is less than the threshold value of ≤ 0.5 cm, patients should be referred for further investigations with DXA.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, College of Medicine, University of Dammam, King Fahd Hospital of the University, Alkhobar, Saudi Arabia.

ABSTRACT

Background and objective: Bone mineral density measurements with absorptiometry dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing low bone mass and risk for fragility fractures. DXA is not available at every center, and physicians require an alternative method of diagnosis before referring patients. We conducted this study to assess and compare total cortical thickness (TCT) and its relation to the T score by DXA and its correlation-ship in the diagnosis of osteoporosis.

Patients and methods: Total cortical thickness was carried out in 50 Saudi Arabian females ≥ 45 years with DXA scans and 25 patients with age of ≤ 35 years whose radiographs of the upper tibia were available for analysis. Postero-medial cortical thickness of the tibia was measured 13 cm from the joint line and an average was calculated. The average T score of the spine and the hip was taken. A comparison was made between age, T score, and the TCT. Inter cortical distance (ICD) was measured and compared in both groups. Data were analyzed for predictive value for diagnosis of osteopenia and osteoporosis.

Results: There was a significant association between the T score and the TCT and age. As the age advanced the T score and TCT was very low (<0.05, 95% confidence interval [CI] <0.2). Forty patients were osteopenic and 10 osteoporotic. The T score in the former was - 1.33 ± 0.71 and the later was - 3.22 ± 0.56 (P < 0.0001 95% CI: <-1.67) and the TCT was 0.655 ± 0.06 versus 0.51 ± 0.05 (P < 0.0001 95% CI: <-0.17). In women ≤35 years the average TCT was 0.804 ± 0.155 cm and IMD was 3.34 ± 0.45 cm.

Conclusions: We conclude that if TCT is less than the threshold value of ≤ 0.5 cm, patients should be referred for further investigations with DXA. We believe that further studies are needed to confirm our findings and in areas where DXA is not available, based on the TCT measurement anti-osteoporotic therapy could be initiated when other risk factors for osteoporosis is present.

No MeSH data available.


Related in: MedlinePlus

Measurement of medial tibial cortical thickness
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Figure 1: Measurement of medial tibial cortical thickness

Mentions: The data collected for each patient included age, sex, radiographs and DXA records from the picture archiving and communication system (syngo. plaza - Siemens Healthcare, USA). Plain radiographs of the antero-posterior and lateral views of the tibia were available for analysis with DXA (Hologic, Waltham, MA, USA). Two measurements were taken of the medial and the posterior cortex of the tibia from 13 cm from the joint line with a precision of 0.1 mm [Figures 1 and 2]. The average of the two measurements was taken and termed as tibial cortical thickness. For the comparison, average measurements of T score of the Hip and spine were taken. Intra-cortical width and TCT was measured at 13 cm in the antero-posterior view in patients of ≤35 years who had a preexisting radiograph of the tibia in the syngo.plaza - Siemens Healthcare, USA - System. ICD was measured in both groups at 13 cm from the top of the tibia.


Tibial cortical thickness: A dependable tool for assessing osteoporosis in the absence of dual energy X-ray absorptiopmetry.

Sadat-Ali M, Elshaboury E, Al-Omran AS, Azam MQ, Syed A, Gullenpet AH - Int J Appl Basic Med Res (2015 Jan-Apr)

Measurement of medial tibial cortical thickness
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318096&req=5

Figure 1: Measurement of medial tibial cortical thickness
Mentions: The data collected for each patient included age, sex, radiographs and DXA records from the picture archiving and communication system (syngo. plaza - Siemens Healthcare, USA). Plain radiographs of the antero-posterior and lateral views of the tibia were available for analysis with DXA (Hologic, Waltham, MA, USA). Two measurements were taken of the medial and the posterior cortex of the tibia from 13 cm from the joint line with a precision of 0.1 mm [Figures 1 and 2]. The average of the two measurements was taken and termed as tibial cortical thickness. For the comparison, average measurements of T score of the Hip and spine were taken. Intra-cortical width and TCT was measured at 13 cm in the antero-posterior view in patients of ≤35 years who had a preexisting radiograph of the tibia in the syngo.plaza - Siemens Healthcare, USA - System. ICD was measured in both groups at 13 cm from the top of the tibia.

Bottom Line: Inter cortical distance (ICD) was measured and compared in both groups.There was a significant association between the T score and the TCT and age.We conclude that if TCT is less than the threshold value of ≤ 0.5 cm, patients should be referred for further investigations with DXA.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, College of Medicine, University of Dammam, King Fahd Hospital of the University, Alkhobar, Saudi Arabia.

ABSTRACT

Background and objective: Bone mineral density measurements with absorptiometry dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing low bone mass and risk for fragility fractures. DXA is not available at every center, and physicians require an alternative method of diagnosis before referring patients. We conducted this study to assess and compare total cortical thickness (TCT) and its relation to the T score by DXA and its correlation-ship in the diagnosis of osteoporosis.

Patients and methods: Total cortical thickness was carried out in 50 Saudi Arabian females ≥ 45 years with DXA scans and 25 patients with age of ≤ 35 years whose radiographs of the upper tibia were available for analysis. Postero-medial cortical thickness of the tibia was measured 13 cm from the joint line and an average was calculated. The average T score of the spine and the hip was taken. A comparison was made between age, T score, and the TCT. Inter cortical distance (ICD) was measured and compared in both groups. Data were analyzed for predictive value for diagnosis of osteopenia and osteoporosis.

Results: There was a significant association between the T score and the TCT and age. As the age advanced the T score and TCT was very low (<0.05, 95% confidence interval [CI] <0.2). Forty patients were osteopenic and 10 osteoporotic. The T score in the former was - 1.33 ± 0.71 and the later was - 3.22 ± 0.56 (P < 0.0001 95% CI: <-1.67) and the TCT was 0.655 ± 0.06 versus 0.51 ± 0.05 (P < 0.0001 95% CI: <-0.17). In women ≤35 years the average TCT was 0.804 ± 0.155 cm and IMD was 3.34 ± 0.45 cm.

Conclusions: We conclude that if TCT is less than the threshold value of ≤ 0.5 cm, patients should be referred for further investigations with DXA. We believe that further studies are needed to confirm our findings and in areas where DXA is not available, based on the TCT measurement anti-osteoporotic therapy could be initiated when other risk factors for osteoporosis is present.

No MeSH data available.


Related in: MedlinePlus