title: Cross-sectional DXA and MR measures of tibial periarticular bone associate with radiographic knee osteoarthritis severity.
abstract: OBJECTIVE
  We evaluated the relationship of medial proximal tibial periarticular areal bone mineral density (paBMD) and trabecular morphometry and determined whether these bone measures differed across radiographic medial joint space narrowing (JSN) scores.
  
  
  METHODS
  482 participants of the Osteoarthritis Initiative (OAI) Bone Ancillary Study had knee dual X-ray absorptiometry (DXA) and trabecular bone 3T magnetic resonance imaging (MRI) exams assessed at the same visit. Medial proximal tibial paBMD was measured on DXA and apparent trabecular bone volume fraction (aBV/TV), thickness (aTb.Th), number (aTb.N), and spacing (aTb.Sp) were determined from MR images. Radiographs were assessed for medial JSN scores (0-3). We evaluated associations between medial paBMD and trabecular morphometry. Whisker plots with notches of these measures versus medial JSN scores were generated and presented.
  
  
  RESULTS
  Mean age was 63.9 (9.2) years, BMI 29.6 (4.8) kg/m(2), and 53% were male. The Spearman correlation coefficients between DXA-measured medial paBMD and aBV/TV was 0.61 [95% confidence interval (CI) 0.55-0.66]; between paBMD and aTb.Th was 0.38 (95%CI 0.30-0.46); paBMD and aTb.N was 0.65 (95%CI 0.60-0.70); paBMD and aTb.Sp was -0.65 (95%CI -0.70 to -0.59). paBMD and the trabecular metrics were associated with medial JSN scores.
  
  
  CONCLUSIONS
  The moderate associations between periarticular trabecular bone density and morphometry and their relationship with greater severity of knee OA support hypotheses of remodeling and/or microscopic compression fractures in the natural history of OA. Longitudinal studies are needed to assess whether knee DXA will be a predictor of OA progression. Further characterization of the periarticular bone in OA utilizing complementary imaging modalities will help clarify OA pathophysiology.
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center, Medical Care Line and Research Care Line, Houston, TX, USA. ghlo@bcm.edu
authors.forename: G H
authors.initials: GH
authors.lastname: Lo
authors.forename: A M
authors.initials: AM
authors.lastname: Tassinari
authors.forename: J B
authors.initials: JB
authors.lastname: Driban
authors.forename: L L
authors.initials: LL
authors.lastname: Price
authors.forename: E
authors.initials: E
authors.lastname: Schneider
authors.forename: S
authors.initials: S
authors.lastname: Majumdar
authors.forename: T E
authors.initials: TE
authors.lastname: McAlindon
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D013977:Tibia / Q000503:physiopathology*