Age- and gender-dependent changes in three-dimensional microstructure of cortical and trabecular bone at the human femoral neck

Chen, Huayue; Zhou, Xiangrong; Shoumura, Shízuko; Emura, S.; Bunai, Yasuo

doi:10.1007/s00198-009-0993-z

Cited by 137 publications

(142 citation statements)

References 56 publications

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“…that most humerus fractures sustained above the age of 50 years were associated with minimal trauma (60.2%), with the incidence being higher in women than in men, and localization at the proximal humerus accounting for some 85% of the fractures. We observed a significant and negative relationship between the Ct.Th of the humerus and age, consistent with age-induced bone loss, (27)(28)(29)(30) indicating that our population was representative of elderly patients with humeral fractures. Shaft fractures accounted for 10% of low-energy humeral fractures, and occurred more frequently in women than in men.…”

Section: Discussionsupporting

confidence: 65%

Low-energy fractures of the humeral shaft and bisphosphonate use

Yavropoulou

Giusti

Ramautar

et al. 2012

Journal of Bone and Mineral Research

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Atypical fractures of the femur have been reported to occur in patients on long-term treatment with bisphosphonates; however, causality has not been proven, and it is not known whether similar fractures may occur in other long bones. We addressed this issue by examining the relationship between humeral shaft fractures and bisphosphonate use. We identified all patients aged !50 years consecutively admitted to a single center with a new fracture of the humerus. All individual radiographs were examined and fracture site was classified. A case-control study was undertaken in patients with humeral shaft fractures, and controls were sex-and age-matched patients with proximal humeral fractures in a 1:4 ratio. Patients with shaft fractures and radiographic characteristics similar to those of atypical femoral fractures were compared with those with ordinary shaft fractures. The association between ''atypical'' fractures and bisphosphonate or glucocorticoid use was examined. A total of 198 patients had a low-energy fracture of the humerus; 20 of these patients had a shaft fracture (10%). These 20 patients (cases) were matched with 80 patients with proximal fractures (controls). Bisphosphonates were used by 5% of cases and by 6.3% of controls (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.09-6.85); glucocorticoids were used by 10% of cases and 8.8% of controls (OR, 1.15; 95% CI, 0.23-5.83). There was no difference in cortical thickness between cases and controls and bisphosphonate or glucocorticoid users and nonusers. Four of the 20 patients with shaft fractures had ''atypical'' radiographic features, with significantly increased cortical thickness, but none of these had ever been treated with bisphosphonates or glucocorticoids. Our results show that low-energy fractures of the humeral shaft with ''atypical'' radiographic characteristics are infrequent and are not associated with the use of bisphosphonates or glucocorticoids. ß

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Section: Discussionsupporting

confidence: 65%

Low-energy fractures of the humeral shaft and bisphosphonate use

Yavropoulou

Giusti

Ramautar

et al. 2012

Journal of Bone and Mineral Research

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“…Our findings at the tibia are consistent with results of a recent mCT study of human femoral neck cadavers that indicated the relationship with age was similar in men and women for Tb.N, Tb.Th, and Tb.Sp. (45) Thus patterns of trabecular bone loss may vary with skeletal site. Our regression analyses suggest that BV/TV remains relatively constant at the distal radius until midlife and declines thereafter (Fig.…”

Section: Discussionmentioning

confidence: 99%

Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: A population-based HR-pQCT study

Macdonald¹,

Nishiyama²,

Kang³

et al. 2010

Journal of Bone and Mineral Research

326

223

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In this cross-sectional study, we aimed to predict age-related changes in bone microarchitecture and strength at the distal radius (DR) and distal tibia (DT) in 644 Canadian adults (n ¼ 442 women and 202 men) aged 20 to 99 years. We performed a standard morphologic analysis of the DR and DT with high-resolution peripheral quantitative computed tomography (pQCT) and used finite-element analysis (FEA) to estimate bone strength (failure load) and the load distribution. We also calculated a DR load-to-strength ratio as an estimate of forearm fracture risk. Total bone area, which was 33% larger in young men at both sites, changed similarly with age in women and men at the DT but increased 17% more in men than in women at the DR ( p < .001). Trabecular number and thickness (Tb.Th) were 7% to 20% higher in young men than in young women at both sites, and with the exception of Tb.Th at the DR, which declined more with age in men (À16%) than in women (À2%, p < .01), the age-related decline in these outcomes was similar in women and in men. In the cortex, porosity (Ct.Po) was 31% to 44% lower in young women than in young men but increased 92% to 176% more with age in women than in men ( p < .001). The DR cortex carried 14% more load in young women than in young men, and the percentage of load carried by the DR cortex did not change with age in women but declined by 17% in men ( p < .01). FEA-estimated bone strength was 34% to 47% greater in young men, but the predicted change with age was similar in both sexes. In contrast, the load-to-strength ratio increased 27% more in women than in men with age ( p < .01). These results highlight important site-and sex-specific differences in patterns of age-related bone loss. In particular, the trends for less periosteal expansion, more porous cortices, and a greater percentage of load carried by the DR cortex in women may underpin sex differences in forearm fracture risk. ß

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“…Various methods for filtering and measuring image features have been described before [21,[23][24][25][26][27][28][29][30][31][32]. Similar image features are current in studies on osteoporosis and bone structure [33][34][35][36][37][38][39].…”

Section: Image Processingmentioning

confidence: 99%

Sparseness of the trabecular pattern on dental radiographs: visual assessment compared with semi-automated measurements

Geraets¹,

Lindh²,

Verheij³

2012

The British Journal of Radiology

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Objective: In diagnostic imaging; human perception is the most prominent, yet least studied, source of error. A better understanding of image perception will help to improve diagnostic performance. This study focuses on the perception of coarseness of trabecular patterns on dental radiographs. Comparison of human vision with machine vision should yield knowledge on human perception. Method: In a study on identifying osteoporotic patients, dental radiographs were made from 505 post-menopausal women aged 45-70 years. Intra-oral radiographs of the lower and upper jaws were made. Five observers graded the trabecular pattern as dense, sparse or mixed. The five gradings were combined into a single averaged observer score per jaw. The radiographs were scanned and a region of interest (ROI) was indicated on each. The ROIs were processed with image analysis software measuring 25 image features. Pearson correlation and multiple linear regression were used to compare the averaged observer score with the image features. Results: 14 image features correlated significantly with the observer judgement for both jaws. The strongest correlation was found for the average grey value in the ROI. Other features, describing that osteoporotic patients have fewer but bigger marrow spaces than controls, correlated less with the sparseness of the trabecular pattern than a rather crude measure for structure such as the average grey value. Conclusion: Human perception of the sparseness of trabecular patterns is based more on average grey values of the ROI than on geometric details within the ROI.

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Age- and gender-dependent changes in three-dimensional microstructure of cortical and trabecular bone at the human femoral neck

Cited by 137 publications

References 56 publications

Low-energy fractures of the humeral shaft and bisphosphonate use

Low-energy fractures of the humeral shaft and bisphosphonate use

Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: A population-based HR-pQCT study

Sparseness of the trabecular pattern on dental radiographs: visual assessment compared with semi-automated measurements

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