Vertebral deformities and fractures are associated with MRI and pQCT measures obtained at the distal tibia and radius of postmenopausal women.
CONCLUSIONS
We investigated the association of postmenopausal vertebral deformities and fractures with bone parameters derived from distal extremities using MRI and pQCT. Distal extremity measures showed variable degrees of association with vertebral deformities and fractures, highlighting the systemic nature of postmenopausal bone loss.


BACKGROUND
Prevalent vertebral deformities and fractures are known to predict incident further fractures. However, the association of distal extremity measures and vertebral deformities in postmenopausal women has not been fully established.


METHODS
This study involved 98 postmenopausal women (age range 60-88 years, mean 70 years) with DXA BMD T-scores at either the hip or spine in the range of -1.5 to -3.5. Wedge, biconcavity, and crush deformities were computed on the basis of spine MRI. Vertebral fractures were assessed using Eastell's criterion. Distal tibia and radius stiffness was computed using MRI-based finite element analysis. BMD at the distal extremities were obtained using pQCT.


RESULTS
Several distal extremity MRI and pQCT measures showed negative association with vertebral deformity on the basis of single parameter correlation (r up to 0.67) and two-parameter regression (r up to 0.76) models involving MRI stiffness and pQCT BMD. Subjects who had at least one prevalent vertebral fracture showed decreased MRI stiffness (up to 17.9 %) and pQCT density (up to 34.2 %) at the distal extremities compared to the non-fracture group. DXA lumbar spine BMD T-score was not associated with vertebral deformities.


CONCLUSIONS
The association between vertebral deformities and distal extremity measures supports the notion of postmenopausal osteoporosis as a systemic phenomenon.
University of Pennsylvania School of Medicine, Philadelphia, PA, USA, chamith@mail.med.upenn.edu.
C S
CS
Rajapakse
E A
EA
Phillips
W
W
Sun
M J
MJ
Wald
J F
JF
Magland
P J
PJ
Snyder
F W
FW
Wehrli
D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000209:etiology* / Q000503:physiopathology; D011884:Radius / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D013121:Spinal Curvatures / Q000209:etiology* / Q000503:physiopathology; D016103:Spinal Fractures / Q000209:etiology* / Q000503:physiopathology; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods