Gender differences in trabecular bone architecture of the distal radius assessed with magnetic resonance imaging and implications for mechanical competence.
High-resolution magnetic resonance imaging (hrMRI) has recently made it possible to evaluate trabecular bone structure in vivo. Despite obvious gender differences in fracture incidence at the distal radius, little is known about gender differences in trabecular bone microarchitecture and its relationship to the structural strength of the forearm. The aim of this study was to determine trabecular bone structure in the distal radius of elderly women and men and its correlation with failure loads of the distal radius as determined in a fall configuration. Specifically, we tested the hypotheses that structural indices differ between women and men and that they offer information that is independent from BMD for predicting structural strength. Intact right arms were obtained from 73 formalin-fixed cadavers (age 80+/-11 years, 43 women, 30 men). Trabecular structural indices (apparent bone volume fraction [app. BV/TV], trabecular number [app. Tb.N], trabecular separation [app. Tb.Sp], trabecular thickness [app. Tb.Th] and fractal dimension [Frac.Dim]) were assessed in the distal metaphysis, using hrMRI with 156 microm in-plane resolution and proprietary digital image analysis, while BMD was measured with dual X-ray absorptiometry (DXA). Women displayed significantly lower BMD (-29.8%, p <0.001), app. BV/TV (-8.2%, p <0.05) and app. Tb.Th (-10.2%, p <0.001) than men, whereas app. Tb.N, app. Tb.Sp. and fractal dimension did not differ significantly. Structural parameters differed between normal and osteopenic women (BV/TV: -11%, p <0.01; Tb.Th: -8%, p <0.001) and between normal and osteoporotic women BV/TV: -21%, p <0.001; Tb.Th: -16%, p <0.001). App. BV/TV, app. Tb.Th and fractal dimension provided information independent from BMD in the prediction of radial failure loads in multiple regression models. These findings imply that it should be of clinical interest to monitor both bone mass and trabecular microstructure for predicting osteoporotic fracture risk.
Hudelmaier
Martin
M
Institute of Anatomy and Muskuloskeletal Research, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg, Austria. martin.hudelmaier@pmu.ac.at
Kollstedt
A
A
Lochmüller
E M
EM
Kuhn
V
V
Eckstein
F
F
Link
T M
TM
D015502:Absorptiometry, Photon; D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001696:Biomechanical Phenomena; D015519:Bone Density; D005260:Female; D017709:Fractals; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010024:Osteoporosis / Q000473:pathology / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000473:pathology / Q000503:physiopathology; D011884:Radius / Q000033:anatomy & histology* / Q000502:physiology / Q000503:physiopathology; D012727:Sex Characteristics
Ultrasound Med Biol. 2000 Nov;26(9):1517-23
11179626
Bone. 1998 May;22(5):445-54
9600777
Clin Biomech (Bristol, Avon). 1994 May;9(3):175-9
23916178
Osteoporos Int. 2004 May;15(5):375-81
14740151
Osteoporos Int. 1996;6(5):376-85
8931032
J Orthop Res. 1998 Sep;16(5):629-35
9820289
Calcif Tissue Int. 1991 Oct;49(4):292-7
1760774
Med Phys. 1997 Aug;24(8):1255-61
9284249
Calcif Tissue Int. 1997 Feb;60(2):139-47
9056161
J Bone Miner Res. 2001 Apr;16(4):697-704
11315997
J Bone Miner Res. 1996 Sep;11(9):1356-63
8864911
Clin Orthop Relat Res. 1982 Jun;(166):75-81
7083689
Osteoporos Int. 2003 Jun;14 (4):345-52
12730737
J Clin Densitom. 1999 Summer;2(2):163-73
10499975
Am J Public Health. 1982 Jun;72(6):605-7
7072880
J Bone Miner Res. 1998 Jul;13(7):1175-82
9661082
Osteoporos Int. 2002;13(4):278-87
12030542
Osteoporos Int. 1998;8(1):16-24
9692073
Osteoporos Int. 1999;9(6):469-75
10624452
Bone. 2001 Aug;29(2):101-4
11502469
J Bone Miner Res. 2002 Sep;17 (9):1629-38
12211433
Osteoporos Int. 1999;10(3):231-9
10525716
J Bone Miner Res. 1998 Nov;13(11):1783-90
9797489
Osteoporos Int. 2000;11(10 ):840-6
11199187
Osteoporos Int. 2002 Jan;13(1):6-17
11878456
J Bone Miner Res. 1997 May;12 (5):697-711
9144335
Calcif Tissue Int. 2003 Feb;72 (2):156-65
12370799
Osteoporos Int. 2002;13(2):130-6
11905523
Osteoporos Int. 1995;5(4):262-70
7492865
Bone. 1995 Nov;17(5 Suppl):505S-511S
8573428
Eur Radiol. 1999;9(9):1781-8
10602950
J Orthop Res. 1994 Mar;12(2):211-8
8164094
Calcif Tissue Int. 2001 Mar;68(3):140-5
11351496
Can Assoc Radiol J. 1998 Dec;49(6):390-7
9879267
Invest Radiol. 2001 Apr;36(4):210-7
11283418