Ultrasound bone mass in paraplegic patients.
METHODS
A cross-sectional study.


OBJECTIVE
To clarify the existing controversy with regard to whether paraplegic patients suffer a loss of bone mass in the upper limbs.


METHODS
Madrid, Spain.


METHODS
We evaluated bone mass by phalangeal ultrasonography in 35 male patients with paraplegia (mean age 49+/-12 years), and 25(OH)D3 and PTH to exclude the presence of osteomalacia and secondary hyperparathyroidism. Spasticity was evaluated according to the Ashworth scale. Patients were compared with a control group of 35 healthy male subjects (mean age 48+/-13 years).


RESULTS
The patients had lower 25(OH)D3 levels and amplitude-dependent speed of sound (Ad-SOS) than controls (both P<0.001), and higher PTH levels (P<0.05). There was a statistically significant negative association between PTH and 25(OH)D3 levels (r=-0.52, P<0.0001, CI -0.73 to -0.22) and between 25(OH)D3 and injury duration (r=0.34, P<0.05, CI -0.60 to -0.01). There was no correlation between Ad-SOS values, levels of PTH or 25(OH)D3, and the injury duration. No significant difference in Ad-SOS values was found in patients grouped according to low-to-normal 25(OH)D3 level or according to normal-to-high PTH level. There were no differences in relation to muscle tone. Only alkaline phosphatase and tartrate-resistant acid phosphatase levels were higher in patients than in controls (both P<0.001).


CONCLUSIONS
Paraplegic patients had a loss of phalangeal bone mass that was unrelated to the levels of vitamin D or PTH, or to muscle tone, so it seems to be related to increased bone resorption rather than to deficient bone formation.
Pedrera
J D
JD
Department of Nursing, University of Extremadura, Madrid, Spain.
Mañas
P
P
Gómez
M A
MA
Canal
M L
ML
Lavado
J M
JM
Hernández
E R
ER
Rico
H
H
D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D003430:Cross-Sectional Studies; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000000981:diagnostic imaging*; D012044:Regression Analysis; D014463:Ultrasonography
D015415:Biomarkers