Association of the presence of bone bars on radiographs and low bone mineral density.
OBJECTIVE
Bone bars (BB) are struts of normal trabecular bone that cross the medullary portions of the metaphysis and diaphysis at right angles to the long axis of the shaft. The purpose of this investigation was to determine whether the presence of bone bars (BB) identified on radiographs of the proximal femurs and tibia, predict lower bone mineral density (BMD) as evaluated with dual-energy x-ray absorptiometry (DXA) in the lumbar spine, total hip, or femoral neck.


METHODS
A total of 134 sequential DXA patients underwent radiography of the pelvis, hips, and both knees. The radiographs were evaluated for the presence of BB by two musculoskeletal radiologists who were blinded to DXA results. A t test was used to evaluate the relationship of BB to BMD and a Chi-square test was used to determine if BB were equally distributed among the categories of normal BMD, low bone mass (osteopenia), and osteoporosis.


RESULTS
BB were associated with lower BMD at all measured sites. BB at the intertrochanteric and proximal tibial sites were the most predictive of low BMD while supraacetabular and distal femur BB were less predictive. Osteoporosis or osteopenia is seen in 60-91% of those with BB depending on the side and reader. It is only seen in about 40% of those without BB.


CONCLUSIONS
We conclude that the presence of BB suggest decreased BMD and when correlated with other clinical information, might support further evaluation of BMD.
Department of Radiology, School of Medicine, University of Alabama at Birmingham, JT N304, 625 19th Street South, Birmingham, Al, 35249-6830, UK. mpitt@uabmc.edu
Michael J
MJ
Pitt
Sarah L
SL
Morgan
Robert
R
Lopez-Ben
Rebecca E
RE
Steelman
Nancy
N
Nunnally
Leandria
L
Burroughs
Naomi
N
Fineberg
D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010024:Osteoporosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013977:Tibia / Q000000981:diagnostic imaging* / Q000503:physiopathology*
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