Introduction: Artificial intelligence (AI) technologies have demonstrated high accuracy in detecting overall osteoporosis on chest radiographs, offering significant potential for rapid and accessible osteoporosis screening. However, as bone loss varies by lifestyle and body shape, detecting low bone mineral density (BMD) in specific parts is crucial for early treatment. This study developed and evaluated two deep learning models to detect low BMD in the femoral neck and lumbar vertebrae.
Methods: Data included chest radiographs and dual-energy X-ray absorptiometry (DXA)-measured BMD values [g/cm2] of 2,728 female examinees. Chest radiographs were categorized into low BMD or normal based on the femoral neck (low: 1,358, normal: 1,370) and lumbar vertebrae (low: 562, normal: 2,166). Deep learning models were trained using the ResNet50 architecture with fine-tuning and 10-fold cross-validation. Performance metrics included sensitivity, specificity, overall accuracy, and area under the curve (AUC). Heatmaps generated using Explainable AI visualized regions related to low BMD.
Results: The model achieved 75.3 % overall accuracy (AUC: 0.82) for femoral neck detection and 89.3 % (AUC: 0.96) for lumbar vertebrae detection. Lumbar vertebrae detection showed 14.0 % higher accuracy than the femoral neck. Patients with lumbar vertebrae low BMD exhibited more advanced bone loss compared to those with femoral neck low BMD alone. Heatmaps indicated relevant regions near the clavicle and thoracic vertebrae.
Conclusion: The proposed model accurately detected low BMD in chest radiographs and identified areas of bone loss, demonstrating particularly high performance in lumbar vertebrae detection. Early identification of low BMD enables simple, effective screening and targeted prevention or treatment based on areas of bone loss.
{"title":"Development of AI model for dual detection of low bone mineral density in the femoral neck and lumbar vertebrae using chest radiographs","authors":"Yukino Ohta , Kouichi Yamamoto , Yutaka Katayama , Takahiro Ideta , Hiroaki Matsuzawa , Takao Ichida , Akane Utsunomiya , Takayuki Ishida","doi":"10.1016/j.jocd.2025.101604","DOIUrl":"10.1016/j.jocd.2025.101604","url":null,"abstract":"<div><div><em>Introduction:</em> Artificial intelligence (AI) technologies have demonstrated high accuracy in detecting overall osteoporosis on chest radiographs, offering significant potential for rapid and accessible osteoporosis screening. However, as bone loss varies by lifestyle and body shape, detecting low bone mineral density (BMD) in specific parts is crucial for early treatment. This study developed and evaluated two deep learning models to detect low BMD in the femoral neck and lumbar vertebrae.</div><div><em>Methods:</em> Data included chest radiographs and dual-energy X-ray absorptiometry (DXA)-measured BMD values [g/cm<sup>2</sup>] of 2,728 female examinees. Chest radiographs were categorized into low BMD or normal based on the femoral neck (low: 1,358, normal: 1,370) and lumbar vertebrae (low: 562, normal: 2,166). Deep learning models were trained using the ResNet50 architecture with fine-tuning and 10-fold cross-validation. Performance metrics included sensitivity, specificity, overall accuracy, and area under the curve (AUC). Heatmaps generated using Explainable AI visualized regions related to low BMD.</div><div><em>Results:</em> The model achieved 75.3 % overall accuracy (AUC: 0.82) for femoral neck detection and 89.3 % (AUC: 0.96) for lumbar vertebrae detection. Lumbar vertebrae detection showed 14.0 % higher accuracy than the femoral neck. Patients with lumbar vertebrae low BMD exhibited more advanced bone loss compared to those with femoral neck low BMD alone. Heatmaps indicated relevant regions near the clavicle and thoracic vertebrae.</div><div><em>Conclusion:</em> The proposed model accurately detected low BMD in chest radiographs and identified areas of bone loss, demonstrating particularly high performance in lumbar vertebrae detection. Early identification of low BMD enables simple, effective screening and targeted prevention or treatment based on areas of bone loss.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101604"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toe grip strength (TGS) measures foot muscle strength and evaluates stability maintenance, as well as the risk of falls. Handgrip strength (HGS) is considered a simple and effective method for assessing overall strength, and it correlates with bone variables. The aim of this study was: first, to investigate the relationship between TGS and overall strength and bone variables; and second, to compare the relationships between TGS and HGS with overall strength and bone variables. This cross-sectional study included 59 Caucasian men aged 60 to 84 years. Participants underwent muscle strength testing using exercises such as the bench press, leg extension, leg curl, and biceps curl, along with assessments of HGS and TGS. Body composition and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry (DXA). TGS was positively correlated with bench press performance (r = 0.68; p < 0.001), leg extension strength (r = 0.72; p < 0.001), leg curl strength (r = 0.83; p < 0.001), and biceps curl strength (r = 0.74; p < 0.001). A strong positive correlation was also observed between TGS and HGS (r = 0.88; p < 0.001). Finally, both TGS and HGS showed significant positive correlations with bone mass (r = 0.62; p < 0.001 and r = 0.68; p < 0.001, for toe grip and handgrip respectively). In conclusion, this study suggests that TGS is as good as HGS as a positive determinant of muscle strength and bone mass in older men.
{"title":"Toe Grip Strength is Another Indicator of Muscle Strength and Bone Mass in Older Men","authors":"Elie Maliha , Christophe Jacob , Nour Khalil , Abdel-Jalil Berro , Rami Abboud , Rawad ElHage","doi":"10.1016/j.jocd.2025.101603","DOIUrl":"10.1016/j.jocd.2025.101603","url":null,"abstract":"<div><div>Toe grip strength (TGS) measures foot muscle strength and evaluates stability maintenance, as well as the risk of falls. Handgrip strength (HGS) is considered a simple and effective method for assessing overall strength, and it correlates with bone variables. The aim of this study was: first, to investigate the relationship between TGS and overall strength and bone variables; and second, to compare the relationships between TGS and HGS with overall strength and bone variables. This cross-sectional study included 59 Caucasian men aged 60 to 84 years. Participants underwent muscle strength testing using exercises such as the bench press, leg extension, leg curl, and biceps curl, along with assessments of HGS and TGS. Body composition and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry (DXA). TGS was positively correlated with bench press performance (<em>r</em> = 0.68; <em>p</em> < 0.001), leg extension strength (<em>r</em> = 0.72; <em>p</em> < 0.001), leg curl strength (<em>r</em> = 0.83; <em>p</em> < 0.001), and biceps curl strength (<em>r</em> = 0.74; <em>p</em> < 0.001). A strong positive correlation was also observed between TGS and HGS (<em>r</em> = 0.88; <em>p</em> < 0.001). Finally, both TGS and HGS showed significant positive correlations with bone mass (<em>r</em> = 0.62; <em>p</em> < 0.001 and <em>r</em> = 0.68; <em>p</em> < 0.001, for toe grip and handgrip respectively). In conclusion, this study suggests that TGS is as good as HGS as a positive determinant of muscle strength and bone mass in older men.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101603"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this study was to identify common errors in DXA measurements at our hospital, establish standardization, and contribute to operator training.
Design: This descriptive study at a single centre analyzed 2375 spine and femur DXA images for errors. The reports were reviewed according to a checklist prepared considering The International Society for Clinical Densitometry(ISCD) official positions. Each image was reviewed by a Radiologist and Physical Medicine and Rehabilitation (PMR) specialist trained in the principles and standards of DXA scanning prior to the study. All the assessments were double-checked by other specialists and any incorrect images were reported. All the scans taken and available during the observation period were reviewed. The study included scan images taken in our centre, including lumbar spine and proximal femur measurements, for which all information was entered correctly and completely. Forearm measurements, whole-body measurements, or measurements performed in children were excluded.
Results: A total of 2375 DXA scan results from a single centre were analyzed. According to the evaluation criteria, 1023 (43.1%) lumbar spine and 1078 (45.4%) proximal femur DXA scans had at least one error. The most common error encountered was the presence of excessive degeneration (31.0%) for lumbar spine results, and inadequate hip internal rotation (23.9%) in the proximal femur results. There were found to be more errors in lumbar measurements according to BMI (p=0.04) and age (p≤0.001), and errors in the femur were higher in male gender (p<0.001).
Conclusions: Although the operator and auto-interpretation error rates in this study were low compared to the literature, the results showed that standardization in operator training is not at the desired level. It is hoped that this study will raise awareness of clinicians about DXA imaging errors, and that the training of clinicians who interpret DXA results should be considered as important as the training of technicians.
{"title":"How accurate are Dual-Energy X-Ray Absorptiometry measurements in clinical practice?: a retrospective single centre study.","authors":"Yunus Burak Bayır, Zeynep Kıraç Ünal, Zeynep Alpoğuz Yılmaz, Bengü Türemenoğulları, Ömer Ata, Emre Adıgüzel","doi":"10.1016/j.jocd.2025.101606","DOIUrl":"10.1016/j.jocd.2025.101606","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify common errors in DXA measurements at our hospital, establish standardization, and contribute to operator training.</p><p><strong>Design: </strong>This descriptive study at a single centre analyzed 2375 spine and femur DXA images for errors. The reports were reviewed according to a checklist prepared considering The International Society for Clinical Densitometry(ISCD) official positions. Each image was reviewed by a Radiologist and Physical Medicine and Rehabilitation (PMR) specialist trained in the principles and standards of DXA scanning prior to the study. All the assessments were double-checked by other specialists and any incorrect images were reported. All the scans taken and available during the observation period were reviewed. The study included scan images taken in our centre, including lumbar spine and proximal femur measurements, for which all information was entered correctly and completely. Forearm measurements, whole-body measurements, or measurements performed in children were excluded.</p><p><strong>Results: </strong>A total of 2375 DXA scan results from a single centre were analyzed. According to the evaluation criteria, 1023 (43.1%) lumbar spine and 1078 (45.4%) proximal femur DXA scans had at least one error. The most common error encountered was the presence of excessive degeneration (31.0%) for lumbar spine results, and inadequate hip internal rotation (23.9%) in the proximal femur results. There were found to be more errors in lumbar measurements according to BMI (p=0.04) and age (p≤0.001), and errors in the femur were higher in male gender (p<0.001).</p><p><strong>Conclusions: </strong>Although the operator and auto-interpretation error rates in this study were low compared to the literature, the results showed that standardization in operator training is not at the desired level. It is hoped that this study will raise awareness of clinicians about DXA imaging errors, and that the training of clinicians who interpret DXA results should be considered as important as the training of technicians.</p>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"101606"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-06-10DOI: 10.1016/j.jocd.2025.101602
A.B.M. Kamrul-Hasan , Saptarshi Bhattacharya , Vanishri Ganakumar , Lakshmi Nagendra , Deep Dutta , Fatema Tuz Zahura Aalpona , Joseph M. Pappachan
Background: Trabecular bone score (TBS) independently predicts diabetic bone disease. Many studies have compared TBS in those with and without diabetes, showing inconsistent results. We conducted a systematic review and meta-analysis to evaluate TBS in type 2 diabetes mellitus (T2DM) and clarify its role, considering gender and other confounders.
Methodology: Relevant studies were systematically searched until October 2024 using related terms across multiple databases. RevMan Web and R software were employed to conduct statistical analyses. Meta-analyses utilized random-effects models and the inverse variance statistical method; results were expressed as mean differences (MD) with 95 % confidence intervals. The primary outcome of interest was the MD in TBS (unadjusted or adjusted) between the T2DM and non-diabetes groups.
Results: Data from 27 studies with 16,354 subjects were analyzed. Compared to controls without diabetes, subjects with T2DM exhibited lower unadjusted TBS in the combined sex group (MD -0.10 [-0.18, -0.02], P = 0.01), as well as in men (MD -0.02 [-0.04, -0.00], P = 0.02) and women (MD -0.05 [-0.07, -0.03], P < 0.0001). Individuals with T2DM also had a lower adjusted TBS in the combined sex group (MD -0.16 [-0.24, -0.08], P < 0.0001), men (MD -0.02 [-0.04, -0.00], P = 0.02), and women (MD -0.04 [-0.06, -0.02], P = 0.0005). While lumbar spine bone mineral density (BMD) was higher in individuals with T2DM than in those without across all three groups, total hip BMD was higher in women and the combined sex group; femoral neck BMD was higher only in the combined sex group.
Conclusion: According to the data analyzed in this updated meta-analysis, T2DM appears to adversely affect TBS, despite having a positive effect on BMD; however, the evidence level is very low. Larger and longer-term studies are necessary to explore the implicated factors and potential remedial strategies.
PROSPERO registration number: CRD42024608004
背景：骨小梁评分（TBS）可独立预测糖尿病骨病。许多研究比较了糖尿病患者和非糖尿病患者的TBS，结果不一致。在考虑性别和其他混杂因素的情况下，我们进行了一项系统回顾和荟萃分析，以评估2型糖尿病（T2DM）患者的TBS，并阐明其作用。方法：系统检索相关研究，直到2024年10月，使用多个数据库的相关术语。采用RevMan Web和R软件进行统计分析。meta分析采用随机效应模型和反方差统计方法；结果表示为平均差异（MD），置信区间为95% %。研究的主要终点是T2DM组和非糖尿病组之间TBS的MD（未调整或调整）。结果：分析了27项研究的16,354名受试者的数据。与未患糖尿病的对照组相比，T2DM患者在性别组合组中表现出较低的未调整TBS (MD -0.10 [-0.18, -0.02], P = 0.01)，男性（MD -0.02 [-0.04, -0.00], P = 0.02）和女性（MD -0.05 [-0.07, -0.03], P <； 0.0001）。T2DM患者的调整TBS在性别组合组中也较低（MD -0.16 [-0.24, -0.08], P <； 0.0001），男性（MD -0.02 [-0.04, -0.00], P = 0.02），女性（MD -0.04 [-0.06, -0.02], P = 0.0005）。在所有三组中，T2DM患者的腰椎骨密度（BMD）均高于非T2DM患者，但女性和两性混合组的髋部骨密度（BMD）较高；股骨颈骨密度仅在性别混合组较高。结论：根据这项最新荟萃分析分析的数据，T2DM似乎对TBS有不利影响，尽管对BMD有积极影响；然而，证据水平非常低。有必要进行更大规模和更长期的研究，以探索涉及的因素和潜在的补救策略。普洛斯彼罗注册号：CRD42024608004
{"title":"Trabecular Bone Score in Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis","authors":"A.B.M. Kamrul-Hasan , Saptarshi Bhattacharya , Vanishri Ganakumar , Lakshmi Nagendra , Deep Dutta , Fatema Tuz Zahura Aalpona , Joseph M. Pappachan","doi":"10.1016/j.jocd.2025.101602","DOIUrl":"10.1016/j.jocd.2025.101602","url":null,"abstract":"<div><div><em>Background:</em> Trabecular bone score (TBS) independently predicts diabetic bone disease. Many studies have compared TBS in those with and without diabetes, showing inconsistent results. We conducted a systematic review and meta-analysis to evaluate TBS in type 2 diabetes mellitus (T2DM) and clarify its role, considering gender and other confounders.</div><div><em>Methodology:</em> Relevant studies were systematically searched until October 2024 using related terms across multiple databases. RevMan Web and R software were employed to conduct statistical analyses. Meta-analyses utilized random-effects models and the inverse variance statistical method; results were expressed as mean differences (MD) with 95 % confidence intervals. The primary outcome of interest was the MD in TBS (unadjusted or adjusted) between the T2DM and non-diabetes groups.</div><div><em>Results:</em> Data from 27 studies with 16,354 subjects were analyzed. Compared to controls without diabetes, subjects with T2DM exhibited lower unadjusted TBS in the combined sex group (MD -0.10 [-0.18, -0.02], <em>P</em> = 0.01), as well as in men (MD -0.02 [-0.04, -0.00], <em>P</em> = 0.02) and women (MD -0.05 [-0.07, -0.03], <em>P</em> < 0.0001). Individuals with T2DM also had a lower adjusted TBS in the combined sex group (MD -0.16 [-0.24, -0.08], <em>P</em> < 0.0001), men (MD -0.02 [-0.04, -0.00], <em>P</em> = 0.02), and women (MD -0.04 [-0.06, -0.02], <em>P</em> = 0.0005). While lumbar spine bone mineral density (BMD) was higher in individuals with T2DM than in those without across all three groups, total hip BMD was higher in women and the combined sex group; femoral neck BMD was higher only in the combined sex group.</div><div><em>Conclusion:</em> According to the data analyzed in this updated meta-analysis, T2DM appears to adversely affect TBS, despite having a positive effect on BMD; however, the evidence level is very low. Larger and longer-term studies are necessary to explore the implicated factors and potential remedial strategies.</div><div><em>PROSPERO registration number:</em> CRD42024608004</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101602"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-30DOI: 10.1016/j.jocd.2025.101629
Dr. Parth Aphale, Himanshu Shekhar, Shashank Dokania
{"title":"Radiation therapy–Associated bone attenuation loss in anorectal cancer:Need for standardized imaging and clinical correlation","authors":"Dr. Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.jocd.2025.101629","DOIUrl":"10.1016/j.jocd.2025.101629","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101629"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-30DOI: 10.1016/j.jocd.2025.101623
Angelo Nigro
Chondrocalcinosis, defined as the radiographic evidence of calcium pyrophosphate dihydrate (CPPD) crystal deposition within joint structures, often presents variably, ranging from asymptomatic forms to overt clinical manifestations. Radiofrequency Echographic Multi Spectrometry (REMS) is an advanced imaging modality traditionally employed for assessing bone mineral density (BMD), but it also exhibits potential in identifying incidental findings suggestive of crystal arthropathies such as chondrocalcinosis. This report presents a case of a 65-year-old female patient with a history of a vertebral fracture, in which REMS detected calcifications consistent with chondrocalcinosis, subsequently verified by conventional radiography. This case underscores the dual utility of REMS in both osteoporosis evaluation and as an ancillary tool for recognizing signs of CPPD deposition. Further research is necessary to delineate the broader implications of REMS in diagnosing and managing chondrocalcinosis.
{"title":"Accidental detection of Chondrocalcinosis through REMS densitometry","authors":"Angelo Nigro","doi":"10.1016/j.jocd.2025.101623","DOIUrl":"10.1016/j.jocd.2025.101623","url":null,"abstract":"<div><div>Chondrocalcinosis, defined as the radiographic evidence of calcium pyrophosphate dihydrate (CPPD) crystal deposition within joint structures, often presents variably, ranging from asymptomatic forms to overt clinical manifestations. Radiofrequency Echographic Multi Spectrometry (REMS) is an advanced imaging modality traditionally employed for assessing bone mineral density (BMD), but it also exhibits potential in identifying incidental findings suggestive of crystal arthropathies such as chondrocalcinosis. This report presents a case of a 65-year-old female patient with a history of a vertebral fracture, in which REMS detected calcifications consistent with chondrocalcinosis, subsequently verified by conventional radiography. This case underscores the dual utility of REMS in both osteoporosis evaluation and as an ancillary tool for recognizing signs of CPPD deposition. Further research is necessary to delineate the broader implications of REMS in diagnosing and managing chondrocalcinosis.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101623"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-10-25DOI: 10.1016/j.jocd.2025.101634
William D. Leslie , Sajjad Aftabi , John T. Schousboe , Diane Krueger , Neil Binkley
{"title":"Corrigendum to “Assessing the Effect of DXA Scanner Drift on Misclassification of Bone Density Change: The Manitoba BMD Registry” Journal of Clinical Densitometry, Volume 28, Issue 4, October–December 2025, 101620","authors":"William D. Leslie , Sajjad Aftabi , John T. Schousboe , Diane Krueger , Neil Binkley","doi":"10.1016/j.jocd.2025.101634","DOIUrl":"10.1016/j.jocd.2025.101634","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101634"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Complex regional pain syndrome (CRPS) is a debilitating condition characterized by chronic pain and functional limitations, with an unclear etiology. Multiple factors are implicated in its pathophysiology. The objective of this study was to investigate differences in bone mineral density (BMD) between the affected and unaffected feet in patients diagnosed with CRPS. Diagnosis was established using the Budapest consensus criteria. We previously described a technique for assessing focal feet BMD using dual-energy X-ray absorptiometry (DXA), focusing on two regions of interest (ROIs) in healthy subjects. We hypothesized that patients with CRPS would exhibit significantly reduced bone mineral density in the affected foot compared with the contralateral unaffected foot.
Methods: A cross-sectional study was conducted to assess BMD differences between the affected and unaffected feet in patients with CRPS.
Results: A total of 17 patients (15 females and 2 males) were included, with a median age of 58 years (range 29-73). Patients with CRPS exhibited significantly lower BMD in both ROIs of the affected limb compared to the unaffected limb (p < 0.05). The median percentage difference in BMD was -8.4 % (-1.3; -15.9) for ROI 1 and -8.9 % (-3.3; -29) for ROI 2.
Conclusion: Our findings indicate a significant decrease in BMD in the affected limb of CRPS patients as assessed by DXA. Although limited by the small sample size, these results suggest that DXA may serve as a valuable tool for evaluating and monitoring treatment responses in individuals with CRPS, potentially guiding therapeutic interventions aimed at preserving bone health.
{"title":"Impaired bone mineral density in patients with complex regional pain syndrome","authors":"Abdala Rubén , Torrecilla Isabel , Mumbach Giselle , Witis Florencia , Mana Daniela , González Pernas Mariana , Sesta Mariela , Zanchetta M. Belén","doi":"10.1016/j.jocd.2025.101632","DOIUrl":"10.1016/j.jocd.2025.101632","url":null,"abstract":"<div><div>Complex regional pain syndrome (CRPS) is a debilitating condition characterized by chronic pain and functional limitations, with an unclear etiology. Multiple factors are implicated in its pathophysiology. The objective of this study was to investigate differences in bone mineral density (BMD) between the affected and unaffected feet in patients diagnosed with CRPS. Diagnosis was established using the Budapest consensus criteria. We previously described a technique for assessing focal feet BMD using dual-energy X-ray absorptiometry (DXA), focusing on two regions of interest (ROIs) in healthy subjects. We hypothesized that patients with CRPS would exhibit significantly reduced bone mineral density in the affected foot compared with the contralateral unaffected foot.</div><div><em>Methods:</em> A cross-sectional study was conducted to assess BMD differences between the affected and unaffected feet in patients with CRPS.</div><div><em>Results:</em> A total of 17 patients (15 females and 2 males) were included, with a median age of 58 years (range 29-73). Patients with CRPS exhibited significantly lower BMD in both ROIs of the affected limb compared to the unaffected limb (<em>p</em> < 0.05). The median percentage difference in BMD was -8.4 % (-1.3; -15.9) for ROI 1 and -8.9 % (-3.3; -29) for ROI 2.</div><div><em>Conclusion:</em> Our findings indicate a significant decrease in BMD in the affected limb of CRPS patients as assessed by DXA. Although limited by the small sample size, these results suggest that DXA may serve as a valuable tool for evaluating and monitoring treatment responses in individuals with CRPS, potentially guiding therapeutic interventions aimed at preserving bone health.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101632"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-22DOI: 10.1016/j.jocd.2025.101620
William D. Leslie , Sajjad Aftabi , John T. Schousboe , Diane Krueger , Neil Binkley
Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is widely used to assess osteoporosis and monitor BMD in untreated and treated individuals. Systematic sources of error can occur with DXA scanners, including calibration drift. Publications suggest a drift tolerance in the range 0.5 % to 1.5 %, but are not evidence- based. The current study was performed to directly determine how varying degrees of simulated DXA calibration drift would affect misclassification of BMD change in routine clinical practice. Using data from the Manitoba Bone Density Program, we accessed results for 14,942 individuals age 40 years and older undergoing baseline and repeat fan-beam DXA measurements of the total hip within an interval of 1-5 years. A small amount of simulated drift (absolute 0.003 g/cm2 or relative 0.25 %) had little effect, and resulted in less than 5 % BMD change misclassification. Misclassification exceeded 10 % with absolute BMD drift greater than 0.006 g/cm2 or relative drift over 0.75 %, and was greater than 35 % for absolute BMD drift of 0.024 g/cm2. Similar trends were seen when results were stratified according to use of anti-osteoporosis medication, when varying the least significant change (LSC), and for evaluating lumbar spine BMD change. In summary, relatively small degrees of DXA calibration drift can have large effects on misclassifying BMD change. Our results support a calibration drift tolerance of 0.006 g/cm2 or 0.5 %. These findings may help to guide timing for DXA scanner servicing and repair.
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