Sex and External Size Specific Limitations in Assessing Bone Health From Adult Hand Radiographs.
Sex and External Size Specific Limitations in Assessing Bone Health From Adult Hand Radiographs.
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从手部X光照片测量第二掌骨的形态参数在临床上用于评估生长和衰老过程中的骨骼健康。了解这些形态参数与掌骨强度和其他解剖部位强度的关系对于提供有关治疗策略和有效性的明智决策至关重要。本研究的目的是评估 11 种形态参数（其中 9 种通过手部 X 光照片测量）与在多个解剖部位评估的实验测量全骨强度的相关程度，并测试这些关联在男性和女性之间是否存在差异。对 28 名白人男性捐赠者（18-89 岁）和 35 名白人女性捐赠者（36-89 岁以上）的第二和第三掌骨、桡骨骨干、股骨骨干和股骨近端的骨形态和强度进行了评估。唯一显示与力量显着相关且没有性别特异性影响的形态参数是皮质面积。从手部X光照片得出的无量纲形态参数与雌性的力量显着相关，但对于雄性来说却很少。男性和女性的掌骨横截面的圆形度与中外侧方向测量的外部宽度之间存在显着相关性。这种横截面形状的变化导致了使用皮质面积和假设圆形横截面估计强度时的系统偏差。观察结果证实了这一点，即使用椭圆公式减少了与使用形态学圆形近似相关的系统偏差。因此，皮质面积是力量的最佳预测因子，相关性不存在性别特异性差异，但由于平面外形状变化，皮质面积也存在局限性。横截面形状对手部X光片测量的外骨宽度的依赖性可能提供一种进一步改善骨骼健康评估和明智决策的方法，以优化力量建设和骨折预防治疗策略。 © 2022 作者。 JBMR Plus 由 Wiley periodicals LLC 代表美国骨与矿物研究学会出版。
Morphological parameters measured for the second metacarpal from hand radiographs are used clinically for assessing bone health during growth and aging. Understanding how these morphological parameters relate to metacarpal strength and strength at other anatomical sites is critical for providing informed decision‐making regarding treatment strategies and effectiveness. The goals of this study were to evaluate the extent to which 11 morphological parameters, nine of which were measured from hand radiographs, relate to experimentally measured whole‐bone strength assessed at multiple anatomical sites and to test whether these associations differed between men and women. Bone morphology and strength were assessed for the second and third metacarpals, radial diaphysis, femoral diaphysis, and proximal femur for 28 white male donors (18–89 years old) and 35 white female donors (36–89+ years old). The only morphological parameter to show a significant correlation with strength without a sex‐specific effect was cortical area. Dimensionless morphological parameters derived from hand radiographs correlated significantly with strength for females, but few did for males. Males and females showed a significant association between the circularity of the metacarpal cross‐section and the outer width measured in the mediolateral direction. This cross‐sectional shape variation contributed to systematic bias in estimating strength using cortical area and assuming a circular cross‐section. This was confirmed by the observation that use of elliptical formulas reduced the systematic bias associated with using circular approximations for morphology. Thus, cortical area was the best predictor of strength without a sex‐specific difference in the correlation but was not without limitations owing to out‐of‐plane shape variations. The dependence of cross‐sectional shape on the outer bone width measured from a hand radiograph may provide a way to further improve bone health assessments and informed decision making for optimizing strength‐building and fracture‐prevention treatment strategies. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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