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Sex and External Size Specific Limitations in Assessing Bone Health From Adult Hand Radiographs.

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Cortical area from hand X-rays best predicts bone strength across sexes, though shape variations introduce bias. Hand-derived measures show sex-specific correlations, informing bone health assessments and fracture prevention strategies.

Keywords:
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Area of Science:

  • Orthopedics
  • Bone Biology
  • Medical Imaging

Background:

  • Hand radiographs are clinically used for bone health assessment.
  • Understanding metacarpal morphology-strength relationships is crucial for treatment decisions.

Purpose of the Study:

  • To assess how 11 morphological parameters (9 from hand radiographs) correlate with experimentally measured bone strength at multiple sites.
  • To determine if these associations differ between males and females.

Main Methods:

  • Assessed bone morphology and strength of second/third metacarpals, radial and femoral diaphyses, and proximal femur in 28 males and 35 females.
  • Correlated morphological parameters with whole-bone strength, analyzing sex-specific differences.

Main Results:

  • Cortical area was the only parameter significantly correlating with strength across sexes.
  • Hand radiograph parameters showed significant strength correlations in females but few in males.
  • Metacarpal cross-sectional shape variations biased strength estimation using circular assumptions; elliptical formulas reduced bias.

Conclusions:

  • Cortical area is the best sex-independent predictor of bone strength, but shape variations limit accuracy.
  • Hand radiograph-derived morphology, considering cross-sectional shape, can enhance bone health assessment and fracture prevention strategies.