Pub Date : 2025-10-01DOI: 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}
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 : 2025-10-01DOI: 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}
Pub Date : 2025-10-01DOI: 10.1016/j.jocd.2025.101626
Sumbal Javaid , Qi Meng , Xinwei Wang , Chao Ma , Yanlin Duan , Shuman Yang
We examined the association of cognitive function with bone mineral density (BMD), osteoporosis, and osteopenia. We identified 1070 participants (528 men) aged ≥60 years or older from the NHANES, 2013-2014. BMD was measured using dual-energy X-ray absorptiometry (DXA). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). After adjusting for covariates, one standard deviation increase in the DSST score was associated with increased BMD of the total hip (β = 0.022, P = 0.007), femoral neck (β = 0.024 P = 0.004), and lumbar spine (β = 0.025, P = 0.005) in females. When comparing females in the highest quartile of the DSST score to those in the lowest quartile, the highest score group was associated with a lower risk of osteoporosis [odds ratio (OR), 0.25; 95 % CI, 0.09–0.70] and osteopenia [OR, 0.35 (0.16–0.76)]. No associations were found between the CERAD test, Animal Fluency test, and bone health in females, or between cognitive function and bone health in males. In conclusion, higher DSST scores were associated with higher BMD and lower risk of osteoporosis and osteopenia in elderly females.
我们研究了认知功能与骨密度（BMD）、骨质疏松症和骨质减少症的关系。我们从2013-2014年的NHANES中选取了1070名年龄≥60岁的参与者（528名男性）。采用双能x线骨密度仪（DXA）测量骨密度。认知功能通过建立阿尔茨海默病注册中心（CERAD）单词学习子测试、动物流畅性测试和数字符号替代测试（DSST）进行评估。在调整协变量后，DSST评分的一个标准差增加与女性全髋（β = 0.022, P = 0.007）、股骨颈（β = 0.024 P = 0.004）和腰椎（β = 0.025, P = 0.005）的骨密度增加相关。当比较DSST评分最高四分位数的女性与最低四分位数的女性时，得分最高的组与骨质疏松症的风险较低相关[比值比（OR）， 0.25；95% CI, 0.09-0.70]和骨质减少[OR， 0.35(0.16-0.76)]。没有发现CERAD测试、动物流畅性测试和女性骨骼健康之间的关联，也没有发现男性认知功能和骨骼健康之间的关联。综上所述，DSST评分越高，老年女性的骨密度越高，骨质疏松和骨质减少的风险越低。
{"title":"Association Between Cognitive Functions and Bone Health in the Elderly: The NHANES, 2013-2014","authors":"Sumbal Javaid , Qi Meng , Xinwei Wang , Chao Ma , Yanlin Duan , Shuman Yang","doi":"10.1016/j.jocd.2025.101626","DOIUrl":"10.1016/j.jocd.2025.101626","url":null,"abstract":"<div><div>We examined the association of cognitive function with bone mineral density (BMD), osteoporosis, and osteopenia. We identified 1070 participants (528 men) aged ≥60 years or older from the NHANES, 2013-2014. BMD was measured using dual-energy X-ray absorptiometry (DXA). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning sub-test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). After adjusting for covariates, one standard deviation increase in the DSST score was associated with increased BMD of the total hip (<em>β</em> = 0.022, <em>P</em> = 0.007), femoral neck (<em>β</em> = 0.024 <em>P</em> = 0.004), and lumbar spine (<em>β</em> = 0.025, <em>P</em> = 0.005) in females. When comparing females in the highest quartile of the DSST score to those in the lowest quartile, the highest score group was associated with a lower risk of osteoporosis [odds ratio (OR), 0.25; 95 % CI, 0.09–0.70] and osteopenia [OR, 0.35 (0.16–0.76)]. No associations were found between the CERAD test, Animal Fluency test, and bone health in females, or between cognitive function and bone health in males. In conclusion, higher DSST scores were associated with higher BMD and lower risk of osteoporosis and osteopenia in elderly females.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101626"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208172","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 : 2025-10-01DOI: 10.1016/j.jocd.2025.101627
Benil Nesli ATA , Ece CINAR
Objectives: To assess the relationship between bone mineral density (BMD) and sagittal spinopelvic alignment in postmenopausal women with low bone mass.
Methods: Ninety-two postmenopausal women diagnosed with osteopenia or osteoporosis based on DEXA T-scores were retrospectively analyzed. Spinopelvic parameters—sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis (LL)—were measured using lateral radiographs. Clinical and demographic variables were compared between groups using appropriate statistical methods.
Results: Among all parameters, only SS showed a statistically significant difference between osteoporotic and osteopenic women (p = 0.037). No significant correlations were found between BMD and parity, menopause age, or vitamin D levels. Osteoporotic women had lower SS values. Other spinopelvic and demographic parameters did not differ significantly between groups.
Conclusion: Alterations in SS may represent early postural and biomechanical adaptations to declining bone strength in postmenopausal women. As a determinant of sagittal alignment, SS influences pelvic orientation and lumbar curvature. Its reduction may signal a forward shift in the center of gravity, increasing fall risk. Incorporating SS evaluation into standard imaging may aid early identification of at-risk individuals. Prospective studies are needed to confirm its clinical relevance and predictive value for fractures and functional decline.
{"title":"Sacral Slope as an Early Marker of Postural Change in Postmenopausal Women with Low Bone Mass","authors":"Benil Nesli ATA , Ece CINAR","doi":"10.1016/j.jocd.2025.101627","DOIUrl":"10.1016/j.jocd.2025.101627","url":null,"abstract":"<div><div><em>Objectives:</em> To assess the relationship between bone mineral density (BMD) and sagittal spinopelvic alignment in postmenopausal women with low bone mass.</div><div><em>Methods:</em> Ninety-two postmenopausal women diagnosed with osteopenia or osteoporosis based on DEXA T-scores were retrospectively analyzed. Spinopelvic parameters—sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis (LL)—were measured using lateral radiographs. Clinical and demographic variables were compared between groups using appropriate statistical methods.</div><div><em>Results:</em> Among all parameters, only SS showed a statistically significant difference between osteoporotic and osteopenic women (p = 0.037). No significant correlations were found between BMD and parity, menopause age, or vitamin D levels. Osteoporotic women had lower SS values. Other spinopelvic and demographic parameters did not differ significantly between groups.</div><div><em>Conclusion:</em> Alterations in SS may represent early postural and biomechanical adaptations to declining bone strength in postmenopausal women. As a determinant of sagittal alignment, SS influences pelvic orientation and lumbar curvature. Its reduction may signal a forward shift in the center of gravity, increasing fall risk. Incorporating SS evaluation into standard imaging may aid early identification of at-risk individuals. Prospective studies are needed to confirm its clinical relevance and predictive value for fractures and functional decline.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101627"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259841","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}
Objectives: The weakening of the musculoskeletal system in women suffering from osteoporosis often leads to an increased risk of falls. We delved into the relationship between the echo intensity (EI) of the resting and contracting medial gastrocnemius muscle (MG) and its correlation with postural sway, appendicular skeletal muscle mass index (ASMI), and the fall efficacy scale (FES) in women over 60 diagnosed with osteoporosis.
Methods: This observational-analytical study welcomed the voluntary participation of 40 women diagnosed with osteoporosis. We employed DEXA to assess ASMI, leg fat/lean-mass, and musculoskeletal sonography to measure muscle architecture and the EI of the MG muscle during both rest and activity. We determined the center of pressure sway (CoP) in the anteroposterior (AP) and mediolateral (ML) directions during the double stance position.
Results: A significant positive correlation was observed between the EI during rest and contraction with FES (r=0.527 and 0.570, respectively). An inverse correlation was noted between MG-activation EI and ASMI (r=-0.486). Interestingly, the MG-activation EI emerged as the best predictor for the sway velocity AP and ML (R2=22 % and 23 %, respectively), and sway average amplitude ML (R2=24 %).
Conclusion: It was found that gastrocnemius muscle EI during rest and activity was associated with AP/ML postural sway, ASMI, leg fat/lean-mass and FES. MG-EI, especially during activation, could be considered as a promising noninvasive marker of muscle quality with a significant association with CoP sway and fall risk in women with osteoporosis at screening.
{"title":"Correlation of Gastrocnemius Muscle Quality With Balance, Appendicular Skeletal Mass, and Fall Risk in Osteoporotic Women: A Musculoskeletal Sonography Assessment During Rest and Activity","authors":"Elham Bagheri Yekta , Giti Torkaman , Leila Aghaghazvini","doi":"10.1016/j.jocd.2025.101633","DOIUrl":"10.1016/j.jocd.2025.101633","url":null,"abstract":"<div><div><em>Objectives:</em> The weakening of the musculoskeletal system in women suffering from osteoporosis often leads to an increased risk of falls. We delved into the relationship between the echo intensity (EI) of the resting and contracting medial gastrocnemius muscle (MG) and its correlation with postural sway, appendicular skeletal muscle mass index (ASMI), and the fall efficacy scale (FES) in women over 60 diagnosed with osteoporosis.</div><div><em>Methods:</em> This observational-analytical study welcomed the voluntary participation of 40 women diagnosed with osteoporosis. We employed DEXA to assess ASMI, leg fat/lean-mass, and musculoskeletal sonography to measure muscle architecture and the EI of the MG muscle during both rest and activity. We determined the center of pressure sway (CoP) in the anteroposterior (AP) and mediolateral (ML) directions during the double stance position.</div><div><em>Results:</em> A significant positive correlation was observed between the EI during rest and contraction with FES (r=0.527 and 0.570, respectively). An inverse correlation was noted between MG-activation EI and ASMI (r=-0.486). Interestingly, the MG-activation EI emerged as the best predictor for the sway velocity AP and ML (R<sup>2</sup>=22 % and 23 %, respectively), and sway average amplitude ML (R<sup>2</sup>=24 %).</div><div><em>Conclusion:</em> It was found that gastrocnemius muscle EI during rest and activity was associated with AP/ML postural sway, ASMI, leg fat/lean-mass and FES. MG-EI, especially during activation, could be considered as a promising noninvasive marker of muscle quality with a significant association with CoP sway and fall risk in women with osteoporosis at screening.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101633"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319008","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 : 2025-10-01DOI: 10.1016/j.jocd.2025.101628
E. Michael Lewiecki , Robert A. Adler , Paul A. Anderson , John P. Bilezikian , David W. Dempster , Pouneh K. Fazeli , Michael R. McClung , Eric T. Rush , Christine M. Swanson , S. Bobo Tanner
The 2025 Santa Fe Bone Symposium (SFBS) was a combined in-person and virtual “hybrid” meeting based in Santa Fe, New Mexico, USA, on August 8-9, 2025. There were an equivalent number of in-person and remote attendees from throughout the USA and other countries. The SFBS was immediately preceded, on August 6-7, 2025, by the 2-day Endocrine Fellows Foundation-Santa Fe Bone Symposium Workshop on Metabolic Bone Diseases. This preceptorship included basic bone biology, osteoporosis, parathyroid and rare bone diseases. Most of the fellows attended the SFBS, for a total of 4 days of non-stop education in skeletal health. The topics covered at the SFBS included controversies and consensus in the use of dual-energy X-ray absorptiometry; management of osteoporosis medication side-effects; lessons learned from bone biopsies; osteoporosis in men and premenopausal women; update on treatment of rare bone diseases; parathyroid hormone and skeletal health; periprosthetic fractures; update on Bone Health ECHO; and much more. Ancillary events addressed issues such as bone health through the menopause transition, hypophosphatasia, X-linked hypophosphatemia, and osteoanabolic therapy for postmenopausal women with osteoporosis. This report of the proceedings of the 2025 SFBS summarizes the highlights and clinical insights of the plenary presentations.
{"title":"Proceedings of the 2025 Santa Fe Bone Symposium: Current concepts in the care of patients with osteoporosis, parathyroid disorders, and rare bone diseases","authors":"E. Michael Lewiecki , Robert A. Adler , Paul A. Anderson , John P. Bilezikian , David W. Dempster , Pouneh K. Fazeli , Michael R. McClung , Eric T. Rush , Christine M. Swanson , S. Bobo Tanner","doi":"10.1016/j.jocd.2025.101628","DOIUrl":"10.1016/j.jocd.2025.101628","url":null,"abstract":"<div><div>The 2025 Santa Fe Bone Symposium (SFBS) was a combined in-person and virtual “hybrid” meeting based in Santa Fe, New Mexico, USA, on August 8-9, 2025. There were an equivalent number of in-person and remote attendees from throughout the USA and other countries. The SFBS was immediately preceded, on August 6-7, 2025, by the 2-day Endocrine Fellows Foundation-Santa Fe Bone Symposium Workshop on Metabolic Bone Diseases. This preceptorship included basic bone biology, osteoporosis, parathyroid and rare bone diseases. Most of the fellows attended the SFBS, for a total of 4 days of non-stop education in skeletal health. The topics covered at the SFBS included controversies and consensus in the use of dual-energy X-ray absorptiometry; management of osteoporosis medication side-effects; lessons learned from bone biopsies; osteoporosis in men and premenopausal women; update on treatment of rare bone diseases; parathyroid hormone and skeletal health; periprosthetic fractures; update on Bone Health ECHO; and much more. Ancillary events addressed issues such as bone health through the menopause transition, hypophosphatasia, X-linked hypophosphatemia, and osteoanabolic therapy for postmenopausal women with osteoporosis. This report of the proceedings of the 2025 SFBS summarizes the highlights and clinical insights of the plenary presentations.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101628"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324308","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 : 2025-09-08DOI: 10.1016/j.jocd.2025.101625
Daniel G. Whitney , Michelle S. Caird , Edward A. Hurvitz , Karl J. Jepsen
Introduction/background: Multi-trait vs. single trait approaches, such as dis-integration patterns of key size-mass traits, may better capture the heterogeneity of bone strength profiles for skeletally complex populations like adults with cerebral palsy (CP). The objective was to assess if dis-integration of dual-energy x-ray absorptiometry (DXA)-derived bone traits predict fracture incidence among adults with CP.
Methodology: This was a retrospective cohort study including n=75 adults with CP with a hip DXA from 01/01/2012-03/05/2021 from a single Medical Center; individuals were followed through 9/12/2023 for fracture incidence. Logistic regression estimated the odds ratio (OR) of fracture by the exposure, an interaction between (1) the residual of the BMC-area linear regression and (2) bone area, after adjusting for confounders. Discrimination (c-statistic) was assessed to compare whether the primary exposure or BMD better predicted incident fracture.
Results: Femoral neck BMC-area residual was associated fracture incidence (n=19 fractures) but was conditional on bone area (P-for-interaction, 0.026-0.067). A lower residual was associated with increased OR for smaller areas (e.g., at 10th percentile of area, OR = 1.18; 95 %CI = 0.96-1.45), but a lower OR for larger areas (e.g., at 90th percentile of area, OR = 0.88; 95 %CI = 0.77-1.02). The primary exposure had higher discrimination of incident fracture compared to BMD across all unadjusted and adjusted models (c-statistic range 0.69-0.84 vs. 0.49-0.79, respectively).
Conclusions: Dis-integration of key size-mass bone traits was associated with incident fracture and was a stronger predictor of fracture compared to BMD in this clinical cohort of adults with CP.
介绍/背景：多性状与单性状方法，如关键尺寸-质量性状的分解模式，可能更好地捕捉骨骼复杂人群（如脑瘫（CP）成人）骨强度谱的异质性。目的是评估双能x线吸收仪（DXA）衍生的骨骼特征的瓦解是否能预测成年CP患者的骨折发生率。方法：这是一项回顾性队列研究，包括n=75名患有髋关节DXA的成年CP患者，时间为2012年1月1日至2021年3月5日，来自单一医疗中心；随访至2023年9月12日，观察骨折发生率。在调整混杂因素后，Logistic回归通过暴露估计骨折的优势比（OR），这是(1)BMC-area线性回归的残差和(2)骨面积之间的相互作用。判别性（c-statistic）被评估来比较初次暴露或骨密度是否能更好地预测骨折。结果：股骨颈BMC-area残差与骨折发生率相关（n=19例骨折），但与骨面积有关（相互作用p值为0.026-0.067）。较低的残留与增加或较小的地区(例如,在第十百分位的区域,或 = 1.18;95 CI % = 0.96 - -1.45),但较低的或更大的区域(例如,在第90个百分位的区域,或 = 0.88;95 CI % = 0.77 - -1.02)。在所有未调整和调整的模型中，与骨密度相比，初次暴露对意外骨折的辨别能力更高（c-统计范围分别为0.69-0.84比0.49-0.79）。结论：在成年CP患者的临床队列中，关键尺寸-质量骨特征的解体与偶发性骨折有关，与骨密度相比，它是骨折的更强预测因子。
{"title":"Fracture prediction by bone trait dis-integration using DXA among a clinical cohort of adults with cerebral palsy","authors":"Daniel G. Whitney , Michelle S. Caird , Edward A. Hurvitz , Karl J. Jepsen","doi":"10.1016/j.jocd.2025.101625","DOIUrl":"10.1016/j.jocd.2025.101625","url":null,"abstract":"<div><div><em>Introduction/background:</em> Multi-trait vs. single trait approaches, such as dis-integration patterns of key size-mass traits, may better capture the heterogeneity of bone strength profiles for skeletally complex populations like adults with cerebral palsy (CP). The objective was to assess if dis-integration of dual-energy x-ray absorptiometry (DXA)-derived bone traits predict fracture incidence among adults with CP.</div><div><em>Methodology:</em> This was a retrospective cohort study including n=75 adults with CP with a hip DXA from 01/01/2012-03/05/2021 from a single Medical Center; individuals were followed through 9/12/2023 for fracture incidence. Logistic regression estimated the odds ratio (OR) of fracture by the exposure, an interaction between (1) the residual of the BMC-area linear regression and (2) bone area, after adjusting for confounders. Discrimination (c-statistic) was assessed to compare whether the primary exposure or BMD better predicted incident fracture.</div><div><em>Results:</em> Femoral neck BMC-area residual was associated fracture incidence (n=19 fractures) but was conditional on bone area (<em>P-</em>for-interaction, 0.026-0.067). A lower residual was associated with increased OR for smaller areas (e.g., at 10<sup>th</sup> percentile of area, OR = 1.18; 95 %CI = 0.96-1.45), but a lower OR for larger areas (e.g., at 90<sup>th</sup> percentile of area, OR = 0.88; 95 %CI = 0.77-1.02). The primary exposure had higher discrimination of incident fracture compared to BMD across all unadjusted and adjusted models (c-statistic range 0.69-0.84 vs. 0.49-0.79, respectively).</div><div><em>Conclusions:</em> Dis-integration of key size-mass bone traits was associated with incident fracture and was a stronger predictor of fracture compared to BMD in this clinical cohort of adults with CP.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"29 1","pages":"Article 101625"},"PeriodicalIF":1.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468408","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 : 2025-08-26DOI: 10.1016/j.jocd.2025.101624
Asma Aljaberi , S. Bobo Tanner , E. Michael Lewiecki
Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual learning model established by University of New Mexico in 2015 to enhance global skeletal healthcare by supporting case-based discussions and best-practice sharing among clinicians. This case report highlights the presentation and discussion with Bone Health ECHO participants of a young patient with a history of lupus nephritis and a renal transplant 12 years prior, and maintained on chronic systemic glucocorticoids. Despite normal renal function and bone turnover markers, questions arose regarding the optimal approach to long-term skeletal management as the bone mass density is below expected for age. The discussion provided insights into managing such complex cases, emphasizing the importance of individualized care strategies in patients with unique risk factors for skeletal fragility.
{"title":"Bone Health ECHO Case Report: Optimizing Bone Health in Low Fracture Risk Patient after Renal Transplant Treated with Chronic Glucocorticoids: A Case Study","authors":"Asma Aljaberi , S. Bobo Tanner , E. Michael Lewiecki","doi":"10.1016/j.jocd.2025.101624","DOIUrl":"10.1016/j.jocd.2025.101624","url":null,"abstract":"<div><div>Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual learning model established by University of New Mexico in 2015 to enhance global skeletal healthcare by supporting case-based discussions and best-practice sharing among clinicians. This case report highlights the presentation and discussion with Bone Health ECHO participants of a young patient with a history of lupus nephritis and a renal transplant 12 years prior, and maintained on chronic systemic glucocorticoids. Despite normal renal function and bone turnover markers, questions arose regarding the optimal approach to long-term skeletal management as the bone mass density is below expected for age. The discussion provided insights into managing such complex cases, emphasizing the importance of individualized care strategies in patients with unique risk factors for skeletal fragility.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101624"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104410","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 : 2025-08-05DOI: 10.1016/j.jocd.2025.101621
Mira Al Shoufy , Jamil Nasrallah , Kholoud Al Jebawi , Hady El Etry , Murtaja Satea Shafeea , Ibrahim Hassan , Haya Mohamed , Naseeb Danaf , Hossam Tharwat Ali
Graves' disease, an autoimmune hyperthyroid disorder, negatively affects bone health by increasing osteoclast activity, leading to decreased bone mineral density (BMD) and heightened osteoporosis risk. Bone loss may persist even after thyroid levels normalize, possibly due to thyroid-stimulating hormone receptor antibodies (TRAb). This scoping review evaluates the impact of Graves' disease and its treatment on BMD, focusing on TRAb's role in bone loss. Using Arksey and O’Malley's framework, we searched Medline/PubMed, Scopus, Web of Science, and Cochrane Library for English-language studies on the effects of Graves' disease on adult spine-related bone health. From 2,226 records, 16 studies met the inclusion criteria after screening titles, abstracts, and full texts. Studies focusing primarily on postmenopausal women and older men consistently showed reduced BMD in patients with Graves' disease, especially in the lumbar spine. Elevated TRAb levels correlated with lower BMD, suggesting that TRAb contributes to ongoing bone loss despite achieving an euthyroid state. Anti-thyroid drug therapy partially improved BMD, but bone loss often persisted. Combining bisphosphonates with anti-thyroid therapy enhanced BMD recovery more than anti-thyroid therapy alone. Graves' disease affects bone health through thyroid hormone excess and TRAb-mediated autoimmunity, with persistent bone loss even after achieving an euthyroid state. High-risk groups like postmenopausal women and older men require targeted strategies addressing both thyroid and skeletal health. Future research should focus on therapies targeting TRAb and improving osteoporosis prevention to enhance outcomes.
Graves病是一种自身免疫性甲状腺功能亢进疾病，通过增加破骨细胞活性，导致骨密度（BMD）下降和骨质疏松症风险增加，对骨骼健康产生负面影响。即使甲状腺水平恢复正常，骨质流失仍可能持续存在，这可能是由于促甲状腺激素受体抗体（TRAb）所致。本综述评估了Graves病及其治疗对骨密度的影响，重点关注TRAb在骨质流失中的作用。使用Arksey和O ' malley的框架，我们检索了Medline/PubMed、Scopus、Web of Science和Cochrane Library，查找有关Graves病对成人脊柱相关骨骼健康影响的英语研究。从2226条记录中，筛选标题、摘要和全文后，有16项研究符合纳入标准。主要针对绝经后女性和老年男性的研究一致表明，Graves病患者的骨密度降低，尤其是腰椎。TRAb水平升高与较低的骨密度相关，表明TRAb有助于持续的骨质流失，尽管达到了甲状腺功能正常的状态。抗甲状腺药物治疗部分改善了骨密度，但骨质流失往往持续存在。双膦酸盐联合抗甲状腺治疗比单独抗甲状腺治疗更能促进骨密度恢复。Graves病通过甲状腺激素过量和trab介导的自身免疫影响骨骼健康，即使在达到甲状腺功能正常状态后也会持续骨质流失。像绝经后妇女和老年男性这样的高危人群需要针对甲状腺和骨骼健康的针对性策略。未来的研究应侧重于针对TRAb的治疗和改善骨质疏松症的预防，以提高疗效。
{"title":"Graves' disease and bone mineral density: a scoping review of the impact of graves’ disease on spinal health","authors":"Mira Al Shoufy , Jamil Nasrallah , Kholoud Al Jebawi , Hady El Etry , Murtaja Satea Shafeea , Ibrahim Hassan , Haya Mohamed , Naseeb Danaf , Hossam Tharwat Ali","doi":"10.1016/j.jocd.2025.101621","DOIUrl":"10.1016/j.jocd.2025.101621","url":null,"abstract":"<div><div>Graves' disease, an autoimmune hyperthyroid disorder, negatively affects bone health by increasing osteoclast activity, leading to decreased bone mineral density (BMD) and heightened osteoporosis risk. Bone loss may persist even after thyroid levels normalize, possibly due to thyroid-stimulating hormone receptor antibodies (TRAb). This scoping review evaluates the impact of Graves' disease and its treatment on BMD, focusing on TRAb's role in bone loss. Using Arksey and O’Malley's framework, we searched Medline/PubMed, Scopus, Web of Science, and Cochrane Library for English-language studies on the effects of Graves' disease on adult spine-related bone health. From 2,226 records, 16 studies met the inclusion criteria after screening titles, abstracts, and full texts. Studies focusing primarily on postmenopausal women and older men consistently showed reduced BMD in patients with Graves' disease, especially in the lumbar spine. Elevated TRAb levels correlated with lower BMD, suggesting that TRAb contributes to ongoing bone loss despite achieving an euthyroid state. Anti-thyroid drug therapy partially improved BMD, but bone loss often persisted. Combining bisphosphonates with anti-thyroid therapy enhanced BMD recovery more than anti-thyroid therapy alone. Graves' disease affects bone health through thyroid hormone excess and TRAb-mediated autoimmunity, with persistent bone loss even after achieving an euthyroid state. High-risk groups like postmenopausal women and older men require targeted strategies addressing both thyroid and skeletal health. Future research should focus on therapies targeting TRAb and improving osteoporosis prevention to enhance outcomes.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"29 1","pages":"Article 101621"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435550","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号