Characterizing Bone Mineral Density Using Lumbar Spine Computed Tomography Attenuation in Patients With Distal Radius...

Area of Science:

• Radiology
• Orthopedics
• Endocrinology

Background:

• Distal radius fractures (DRF) are common in adults.
• Bone health evaluation is crucial for patients with DRF.
• Osteoporosis screening is often underutilized in this population.

Purpose of the Study:

• To assess the potential for opportunistic bone mineral density (BMD) screening using L1 vertebra computed tomography (CT) attenuation in patients with DRF.
• To determine the proportion of DRF patients eligible for osteoporosis screening who could be assessed via L1 CT attenuation.
• To compare the diagnostic yield of L1 CT attenuation with dual-energy X-ray absorptiometry (DXA) for osteoporosis detection.

Main Methods:

• Retrospective review of adult patients with DRF over a 5-year period.
• Collected data on age, sex, prior/post-fracture DXA results, and L1 CT attenuation within 6 months of fracture.
• Compared L1 CT availability to DXA scan rates and analyzed CT attenuation values against DXA results in overlapping cohorts.

Main Results:

• Of 1853 DRF patients, 195 had an L1 CT scan.
• Among 685 patients eligible for screening, 10% had L1 CT only, and 2% had both CT and DXA.
• In patients with adequate CT, 78% showed L1 attenuation <135 HU, and 92% <160 HU, indicative of potential osteoporosis.

Conclusions:

• 10% of DRF patients eligible for osteoporosis screening had a usable L1 CT scan for BMD estimation.
• The majority of these patients demonstrated CT attenuation values consistent with osteoporosis.
• Opportunistic L1 CT attenuation screening could increase osteoporosis detection rates by 8% in DRF patients, enhancing screening from 40% to 50% at no additional cost.