Journal of Bone and Mineral Metabolism

, Volume 31, Issue 2, pp 212–221 | Cite as

Cortical and trabecular bone structure analysis at the distal radius—prediction of biomechanical strength by DXA and MRI

  • Thomas Baum
  • Melanie Kutscher
  • Dirk Müller
  • Christoph Räth
  • Felix Eckstein
  • Eva-Maria Lochmüller
  • Ernst J. Rummeny
  • Thomas M. Link
  • Jan S. Bauer
Original Article


The purpose of this study was to investigate whether the combination of dual-energy X-ray absorptiometry (DXA)-based bone mass and magnetic resonance imaging (MRI)-based cortical and trabecular structural measures improves the prediction of radial bone strength. Thirty-eight left forearms were harvested from formalin-fixed human cadavers. Bone mineral content (BMC) and bone mineral density (BMD) of the distal radius were measured using DXA. Cortical and trabecular structural measures of the distal radius were computed in high-resolution 1.5T MR images. Cortical measures included average cortical thickness and cross-sectional area. Trabecular measures included morphometric and texture parameters. The forearms were biomechanically tested in a fall simulation to measure absolute radial bone strength (failure load). Relative radial bone strength was determined by dividing radial failure loads by age, body mass index, radius length, and average radius cross-sectional area, respectively. DXA derived BMC and BMD showed statistically significant (p < 0.05) correlations with absolute and relative radial bone strength (r ≤ 0.78). Correlation coefficients for cortical and trabecular structural measures with absolute and relative radial bone strength amounted up to r = 0.59 and r = 0.74, respectively, (p < 0.05). In combination with DXA-based bone mass, trabecular but not, cortical structural measures, added in multiple regression models significant (p < 0.05) information in predicting absolute and relative radial bone strength (up to R adj = 0.88). Thus, a combination of DXA-based bone mass and MRI-based trabecular structural measures most accurately predicted absolute and relative radial bone strength, whereas structural measures of the cortex did not provide significant additional information in combination with DXA.


Osteoporosis Radius DXA MRI 



This work was supported by grants of the Deutsche Forschungsgemeinschaft (DFG LO 730/3-1 and DFG BA 4085/1-2).

Conflict of interest

All authors have no conflicts of interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2012

Authors and Affiliations

  • Thomas Baum
    • 1
  • Melanie Kutscher
    • 1
  • Dirk Müller
    • 1
    • 2
  • Christoph Räth
    • 3
  • Felix Eckstein
    • 4
  • Eva-Maria Lochmüller
    • 4
  • Ernst J. Rummeny
    • 1
  • Thomas M. Link
    • 5
  • Jan S. Bauer
    • 1
  1. 1.Klinikum rechts der Isar, Institut für RadiologieTechnische Universität MünchenMunichGermany
  2. 2.Institut und Poliklinik für Diagnostische RadiologieUniversitätsklinikum KölnCologneGermany
  3. 3.Max-Planck-Institut für extraterrestrische PhysikGarchingGermany
  4. 4.Institute of Anatomy and Musculoskeletal ResearchParacelsus Medical University SalzburgSalzburgAustria
  5. 5.Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical ImagingUniversity of California San FranciscoSan FranciscoUSA

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