A Correlation Exists Between Subchondral Bone Mineral Density of the Distal Radius and Systemic Bone Mineral Density
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Intraarticular distal radius fractures are common and risk articular congruity owing to disruption of the subchondral bone. Studies regarding microstructure and mechanical properties of the distal radius, however, focus only on the cortical and trabecular bones in the metaphysis and not on the subchondral bone.
This study was conducted to (1) quantify the regional bone mineral density of the subchondral plate in the distal radius; (2) analyze the topographic distribution pattern of the subchondral bone mineral density; and (3) evaluate the correlation between the subchondral bone mineral density and the potentially related clinical factors of age, height, weight, BMI, systemic bone mineral densities, socio-occupational classification, and hand osteoarthritis grading.
Eighty postmenopausal women with a mean age of 68 years (range, 52–88 years) were enrolled in this study. Digital images of the distal radii of the subjects were scanned by conventional CT and processed to provide the regional bone mineral density of the subchondral plate using a CT osteoabsorptiometry technique. The estimated subchondral bone mineral density was analyzed to evaluate the topographic pattern and its correlation with various clinical factors, including age, height, weight, BMI, degree of hand osteoarthritis, socio-occupational class, and systemic bone mineral density measured in the lumbar spine and hip.
During topographic analysis of a densitometric map, a bicentric distribution of the subchondral bone mineral density was found. Among the clinical factors, only the systemic bone mineral density measured by dual-energy x-ray absorptiometry in the femur neck and lumbar spine had a significant correlation with the subchondral bone mineral density of the distal radius.
Systemic bone mineral density correlates substantially with the subchondral bone mineral density of the distal radius as a constitutional factor, whereas other local factors arising from the gravitational load or joint reaction force are not associated with the subchondral bone mineral density of the distal radius.
Level of Evidence
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
- Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long-term results of conservative treatment of fractures of the distal radius. Clin Orthop Relat Res. 1986;206:202–210.
- Andrade SE, Majumdar SR, Chan KA, Buist DS, Go AS, Goodman M, Smith DH, Platt R, Gurwitz JH. Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med. 2003;163:2052–2057. CrossRef
- Burghardt AJ, Kazakia GJ, Link TM, Majumdar S. Automated simulation of areal bone mineral density assessment in the distal radius from high-resolution peripheral quantitative computed tomography. Osteoporos Int. 2009;20:2017–2024. CrossRef
- Carlson KJ, Patel BA. Habitual use of the primate forelimb is reflected in the material properties of subchondral bone in the distal radius. J Anat. 2006;208:659–670. CrossRef
- Cavelaars AE, Kunst AE, Geurts JJ, Helmert U, Lundberg O, Mielck A, Matheson J, Mizrahi A, Mizrahi A, Rasmussen N, Spuhler T, Mackenbach JP. Morbidity differences by occupational class among men in seven European countries: an application of the Erikson-Goldthorpe social class scheme. Int J Epidemiol. 1998;27:222–230. CrossRef
- Cesana G, Ferrario M, Gigante S, Sega R, Toso C, Achilli F. Socio-occupational differences in acute myocardial infarction case-fatality and coronary care in a northern Italian population. Int J Epidemiol. 2001;30(suppl 1):S53–58. CrossRef
- Chaisson CE, Zhang Y, Sharma L, Felson DT. Higher grip strength increases the risk of incident radiographic osteoarthritis in proximal hand joints. Osteoarthritis Cartilage. 2000;8(suppl A):S29–32.
- Chaisson CE, Zhang Y, Sharma L, Kannel W, Felson DT. Grip strength and the risk of developing radiographic hand osteoarthritis: results from the Framingham Study. Arthritis Rheum. 1999;42:33–38. CrossRef
- Clayton RA, Gaston MS, Ralston SH, Court-Brown CM, McQueen MM. Association between decreased bone mineral density and severity of distal radial fractures. J Bone Joint Surg Am. 2009;91:613–619. CrossRef
- Cuddihy MT, Gabriel SE, Crowson CS, Atkinson EJ, Tabini C, O’Fallon WM, Melton LJ 3rd. Osteoporosis intervention following distal forearm fractures: a missed opportunity? Arch Intern Med. 2002;162:421–426. CrossRef
- Engelke K, Libanati C, Liu Y, Wang H, Austin M, Fuerst T, Stampa B, Timm W, Genant HK. Quantitative computed tomography (QCT) of the forearm using general purpose spiral whole-body CT scanners: accuracy, precision and comparison with dual-energy X-ray absorptiometry (DXA). Bone. 2009;45:110–118. CrossRef
- Erikson R, Goldthorpe JH, Portocarero L. Intergenerational class mobility in three Western European Societies: England, France and Sweden. Br J Sociol. 1979;30:415–441. CrossRef
- Fernandez JJ, Gruen GS, Herndon JH. Outcome of distal radius fractures using the short form 36 health survey. Clin Orthop Relat Res. 1997;341:36–41. CrossRef
- Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA. Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am. 2000;82:1063–1070.
- Frost HM. Skeletal structural adaptations to mechanical usage (SATMU): 1. Redefining Wolff’s law: the bone modeling problem. Anat Rec. 1990;226:403–413.
- Frost HM. Skeletal structural adaptations to mechanical usage (SATMU): 2. Redefining Wolff’s law: the remodeling problem. Anat Rec. 1990;226:414–422.
- Gartland JJ Jr, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg Am. 1951;33:895–907.
- Hollevoet N, Verdonk R. Outcome of distal radius fractures in relation to bone mineral density. Acta Orthop Belg. 2003;69:510–514.
- Itoh S, Tomioka H, Tanaka J, Shinomiya K. Relationship between bone mineral density of the distal radius and ulna and fracture characteristics. J Hand Surg Am. 2004;29:123–130. CrossRef
- Kanterewicz E, Yanez A, Perez-Pons A, Codony I, Del Rio L, Diez-Perez A. Association between Colles’ fracture and low bone mass: age-based differences in postmenopausal women. Osteoporos Int. 2002;13:824–828. CrossRef
- Khan SA, de Geus C, Holroyd B, Russell AS. Osteoporosis follow-up after wrist fractures following minor trauma. Arch Intern Med. 2001;161:1309–1312. CrossRef
- Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68:647–659.
- Kopylov P, Johnell O, Redlund-Johnell I, Bengner U. Fractures of the distal end of the radius in young adults: a 30-year follow-up. J Hand Surg Br. 1993;18:45–49. CrossRef
- Macneil JA, Boyd SK. Bone strength at the distal radius can be estimated from high-resolution peripheral quantitative computed tomography and the finite element method. Bone. 2008;42:1203–1213. CrossRef
- Mehlum IS, Kristensen P, Kjuus H, Wergeland E. Are occupational factors important determinants of socioeconomic inequalities in musculoskeletal pain? Scand J Work Environ Health. 2008;34:250–259. CrossRef
- Misch CE, ed. Bone density; a key determinant for clinical success. Contemporary Implant Dentistry. St Louis, MO: Mosby Publishing Inc; 1999:109–118.
- Morin S, Tsang JF, Leslie WD. Weight and body mass index predict bone mineral density and fractures in women aged 40 to 59 years. Osteoporos Int. 2009;20:363–370. CrossRef
- Patel BA, Carlson KJ. Bone density spatial patterns in the distal radius reflect habitual hand postures adopted by quadrupedal primates. J Hum Evol. 2007;52:130–141. CrossRef
- Patel BA, Carlson KJ. Apparent density patterns in subchondral bone of the sloth and anteater forelimb. Biol Lett. 2008;4:486–489. CrossRef
- Pongchaiyakul C, Panichkul S, Songpatanasilp T, Nguyen TV. A nomogram for predicting osteoporosis risk based on age, weight and quantitative ultrasound measurement. Osteoporos Int. 2007;18:525–531. CrossRef
- Porter M, Stockley I. Fractures of the distal radius: intermediate and end results in relation to radiologic parameters. Clin Orthop Relat Res. 1987;220:241–252.
- Pugh JW, Radin EL, Rose RM. Quantitative studies of human subchondral cancellous bone: its relationship to the state of its overlying cartilage. J Bone Joint Surg Am. 1974;56:313–321.
- Radin EL, Paul IL. Does cartilage compliance reduce skeletal impact loads? The relative force-attenuating properties of articular cartilage, synovial fluid, periarticular soft tissues and bone. Arthritis Rheum. 1970;13:139–144. CrossRef
- Varga P, Pahr DH, Baumbach S, Zysset PK. HR-pQCT based FE analysis of the most distal radius section provides an improved prediction of Colles’ fracture load in vitro. Bone. 2010;47:982–988. CrossRef
- Vener MJ, Thompson RC Jr, Lewis JL, Oegema TR Jr. Subchondral damage after acute transarticular loading: an in vitro model of joint injury. J Orthop Res. 1992;10:759–765. CrossRef
- Vilayphiou N, Boutroy S, Sornay-Rendu E, Van Rietbergen B, Munoz F, Delmas PD, Chapurlat R. Finite element analysis performed on radius and tibia HR-pQCT images and fragility fractures at all sites in postmenopausal women. Bone. 2010;46:1030–1037. CrossRef
- Wildner M, Peters A, Raghuvanshi VS, Hohnloser J, Siebert U. Superiority of age and weight as variables in predicting osteoporosis in postmenopausal white women. Osteoporos Int. 2003;14:950–956. CrossRef
- Young CF, Nanu AM, Checketts RG. Seven-year outcome following Colles’ type distal radial fracture: a comparison of two treatment methods. J Hand Surg Br. 2003;28:422–426. CrossRef
- Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study. Am J Epidemiol. 2002;156:1021–1027. CrossRef
- A Correlation Exists Between Subchondral Bone Mineral Density of the Distal Radius and Systemic Bone Mineral Density
Clinical Orthopaedics and Related Research®
Volume 470, Issue 6 , pp 1682-1689
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Orthopedic Surgery, Seoul National University Boramae Medical Center, 39 Boramae-gil Dongjak-gu, Seoul, 156-707, South Korea
- 2. Department of Orthopedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, South Korea