Trabecular Bone Score: Where are we now?
The Trabecular Bone Score is a rather new index obtained at the lumbar spine at the same time as a real bone mineral density. It was developed to reflect bone microarchitecture. It was proposed to be easily used in everyday practice as a surrogate of bone strength. Our aim was to review 1. technical points such as correlations between Trabecular Bone Score and bone microarchitectural parameters, Trabecular Bone Score and bone strength, the effects of dual-energy X-ray absorptiometry image spatial resolution, age, macroarchitecture, body mass index, and osteoarthritis, on Trabecular Bone Score, and 2. evidences to use Trabecular Bone Score for separating individuals with fragility fractures from controls, predicting fragility fractures, and for longitudinally monitoring changes related to treatments. Correlations between Trabecular Bone Score and bone microarchitectural parameters vary widely across bone sites, microarchitectural parameters, and study designs. In vivo, the Trabecular Bone Score explains little of the variance in trabecular microarchitectural parameters. We emphasize that it is a texture parameter. The Trabecular Bone Score is reduced in patients with fragility fracture. Several retrospective and prospective studies have shown its discriminative ability regarding the fracture risk. When combining the areal Bone mineral Density and Trabecular Bone Score, the Trabecular Bone Score remains a predictor of fracture but not the areal Bone Mineral Density. However in prospective studies, the best predictor of fracture remains hip areal bone mineral density. Due to the lack of evidence, we recommend not to use Trabecular Bone Score for following patients treated by anti-osteoporotic drugs.
Radiologie ostéo-articulaire, université Paris VII-Denis-Diderot, Sorbonne Paris Cité, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; B2OA, CNRS UMR 7052, 10, avenue de Verdun, 75010 Paris, France. Electronic address: valerie.bousson@lrb.aphp.fr.
Valérie
V
Bousson
B2OA, CNRS UMR 7052, 10, avenue de Verdun, 75010 Paris, France.
Catherine
C
Bergot
Unité de médecine nucléaire, institut Calot, groupe HOPALE, 62608 Berck/Mer cedex, France.
Bruno
B
Sutter
Inserm U1059, service de rhumatologie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
Thierry
T
Thomas
Médecine générale, 75014 Paris, France.
Sauveur
S
Bendavid
EA4708 I3MTO, university of Orleans, 45100 Orleans, France.
Claude-Laurent
CL
Benhamou
Pôle de gériatrie, centre Antonin-Balmes, CHU de Montpellier, 34295 Montpellier, France.
Hubert
H
Blain
Laboratoire de biologie endocrinienne et ostéo-articulaire, CHU d'Amiens, 80054 Amiens, France.
Michel
M
Brazier
Service de rhumatologie, université Nice Sophia-Antipolis, CHU de Nice-1, 06200 Nice, France.
Véronique
V
Breuil
Service de rhumatologie, université Paris-Descartes, hôpital Cochin, 75014 Paris, France.
Karine
K
Briot
Inserm U 403, service de rhumatologie, hôpital Edouard-Herriot, 69003 Lyon, France.
Roland
R
Chapurlat
Service de rhumatologie, 35500 Vitré, France.
Laure
L
Chapuis
Inserm U606, université Paris-Diderot Paris 7, hôpital Lariboisière, 75010 Paris, France.
Martine
M
Cohen Solal
Inserm ERI 12, service de rhumatologie, CHU d'Amiens, 80054 Amiens cedex 2, France.
Patrice
P
Fardellone
Service de chirurgie orthopédique, hôpital Saint-Antoine, 75012 Paris, France.
Jean-Marc
JM
Feron
Centre de médecine gériatrique, CHR d'Orléans, 45032 Orléans, France.
Jean-Bernard
JB
Gauvain
Centre de rhumatologie, CHU Purpan, 31059 Toulouse, France.
Michel
M
Laroche
Service de rhumatologie, CHU d'Angers, 49933 Angers cedex 09, France.
Erick
E
Legrand
EA4708 I3MTO, university of Orleans, 45100 Orleans, France.
Eric
E
Lespessailles
Service d'endocrinologie-diabétologie pédiatrique, 94270 Le Kremlin-Bicètre, France.
Agnès
A
Linglart
Service de rhumatologie, hôpital Côte-de-Nacre, 14033 Caen cedex 09, France.
Christian
C
Marcelli
Service de rhumatologie, université Paris-Descartes, hôpital Cochin, 75014 Paris, France.
Christian
C
Roux
Inserm U845, Laboratoire d'explorations fonctionnelles, hôpital Necker-Enfants-Malades, 75015 Paris, France.
Jean-Claude
JC
Souberbielle
Centre de ménopause, hôpital Paule-de-Viguier, 31000 Toulouse, France.
Florence
F
Tremollieres
Service d'endocrinologie, CHU de Nancy, 54511 Vandœuvre-lès-Nancy, France.
Georges
G
Weryha
Service de rhumatologie, hôpital Roger-Salengro, 59037 Lille cedex, France.
Bernard
B
Cortet
D015502:Absorptiometry, Photon / Q000379:methods; D015519:Bone Density; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*
Bone mineral density; Densitometry; Fragility fracture; Osteoporosis; Trabecular Bone Score