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Updated: Dec 11, 2025

Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population
Published on: January 31, 2025
Distal radial cortical bone thickness correlates with bone mineral density and can predict osteoporosis: a cohort
ChunXiao Ye1, YingBin Guo1, YouHui Zheng1
1Upper extremity service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian 362000, China.
Purpose:
The purpose of this study was to evaluate the correlation of the bone mineral density (BMD) of the hip and lumbar spine with the distal radius cortical thickness (DRCT) measured on anteroposterior radiographs and establish a method for predicting osteoporosis.
Methods:
We assessed 147 patients aged ≥50 years with distal radius fractures who underwent wrist radiographs and dual-energy X-ray absorptiometry. The DRCT was measured and calculated at two levels of the distal radius of the injured wrist on the radiographs.
Results:
The intra-rater and inter-rater reliability of measures was excellent (intraclass correlation coefficient >0.85). In the Pearson correlation and simple linear regression analyses, the DRCT was positively correlated with hip BMD (r = 0.393, P < 0.01) and lumbar spine BMD (r = 0.529, P < 0.01). Each 1-mm increase in DRCT was associated with a 0.051-g/cm2 increase in hip BMD (R2 = 0.154, P < 0.01) and a 0.080-g/cm2 increase in lumbar spine BMD (R2 = 0.280, P < 0.01). A DRCT of 5.1 mm was selected as the cutoff point for predicting osteoporosis, with the highest Youden index of 0.560, 83.3% sensitivity, 72.7% specificity, and a 66.7% negative predictive value.
Conclusion:
Cortical thickness measurements obtained from anteroposterior wrist radiographs were positively correlated with hip and lumbar spine BMD measurements. This technique is suggested as a rapid, inexpensive, and sensitive method for predicting osteoporosis.
Level Of Evidence:
Diagnostic II.
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