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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

Pearson correlation coefficients between the total cortical thickness values and the T scores by dual-energy X-ray absorptiometry
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Figure 3: Pearson correlation coefficients between the total cortical thickness values and the T scores by dual-energy X-ray absorptiometry

Mentions: The average age of patients was 61.3 ± 10.2 years. Patients were divided into four groups ≤50, 51–60, 61–70 and over 70 years [Table 1]. 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). Table 2 gives a comparison between the control group of patients ≤ 35 years and the study group ≥50 years. The difference between patients below ≤35 and ≥50 years was significant for both parameters at P value for TCT <0.001 CI 95% <0.2264 and IMW was <0.001 CI 95% <0.8233. 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) [Table 3]. Pearson correlation coefficients between the TCT values and the T scores by DXA showed the value of R was 0.77. This is a strong positive correlation, which means that high X variable scores go with high Y variable scores and vice versa. A value of R2, the coefficient of determination was 0.59 [Figure 3].


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)

Pearson correlation coefficients between the total cortical thickness values and the T scores by dual-energy X-ray absorptiometry
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Pearson correlation coefficients between the total cortical thickness values and the T scores by dual-energy X-ray absorptiometry
Mentions: The average age of patients was 61.3 ± 10.2 years. Patients were divided into four groups ≤50, 51–60, 61–70 and over 70 years [Table 1]. 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). Table 2 gives a comparison between the control group of patients ≤ 35 years and the study group ≥50 years. The difference between patients below ≤35 and ≥50 years was significant for both parameters at P value for TCT <0.001 CI 95% <0.2264 and IMW was <0.001 CI 95% <0.8233. 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) [Table 3]. Pearson correlation coefficients between the TCT values and the T scores by DXA showed the value of R was 0.77. This is a strong positive correlation, which means that high X variable scores go with high Y variable scores and vice versa. A value of R2, the coefficient of determination was 0.59 [Figure 3].

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