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Opportunistic measures of bone mineral density at multiple skeletal sites during whole-body CT in polytrauma patients

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Abstract

Summary

Whole-body CT in polytrauma patients revealed bone mineral density variations throughout the skeleton. Bone density was the highest in cranial bones and the lowest in proximal extremities and pelvis. Skeletal age-related changes were generally more pronounced than sex-related changes. Cranial bones did not follow the same aging pattern compared to other bones.

Introduction

Whole-body CT (WBCT) in polytrauma patients enables the detection of numerous incidental findings, such as estimates of bone mineral density (BMD) at multiple skeletal sites. This could help in better understanding of age- and sex-related changes in BMD through skeleton.

Methods

Data were retrospectively retrieved from the WBCTs requested during a 2-year period. BMD, expressed in CT Hounsfield units (HU), was measured at frontal and occipital bone, four vertebrae (C4, Th7, L4, and S2), iliac bone, and proximal humerus and femur. Measurements were done on native and postcontrast scans. The population sample was age-, sex-, and visceral fat volume adjusted for analysis.

Results

A total of 296 patients were included, with a median age of 51 years. BMD varied from the highest HU in cranial bones (629 HU) to the lowest HU in the pelvic bones (114 HU), P < 0.001. Sex differences were independent predictors of BMD in cranial bones and proximal humerus. The age-related decline in BMD was significant in all other bones, but the association with age differed among the measurement’s sites. Visceral fat showed the strongest correlation with the lumbar spine and iliac wing, although multivariate analysis revealed it was not an independent predictor of bone density, such as age and sex.

Conclusions

BMD varies through skeleton, being the highest in the proximal axial skeleton. Age-related changes in BMD are significant and more pronounced than sex-related changes in almost all bones. Cranial bones do not follow the same pattern compared to other bones.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Split-Dalmatia County Health Center, Kavanjinova 2, 21000, Split, Croatia

    Zvonimir Kutleša

  2. Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia

    Ivan Ordulj, Iva Perić, Kristian Jerković & Danijela Budimir Mršić

  3. Department of Orthopaedics and Traumatology, University Hospital Split, Šoltanska 2, 21000, Split, Croatia

    Dino Poljak, Vlado Gavrilović & Šime Devčić

  4. Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia

    Vesna Čapkun

  5. School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia

    Danijela Budimir Mršić

  6. University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000, Split, Croatia

    Danijela Budimir Mršić

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  1. Zvonimir Kutleša
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Correspondence to Danijela Budimir Mršić.

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The study was approved by Institutional Ethical Board, Nr. 2181–147/01/06/M.S.-21–02. For this type of study, formal consent is not required. Personal data were anonymized in accordance to the ethical standards.

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Kutleša, Z., Ordulj, I., Perić, I. et al. Opportunistic measures of bone mineral density at multiple skeletal sites during whole-body CT in polytrauma patients. Osteoporos Int 34, 775–782 (2023). https://doi.org/10.1007/s00198-023-06699-6

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  • DOI: https://doi.org/10.1007/s00198-023-06699-6

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