Can Trabecular Bone Score Enhance Fracture Risk Assessment in Long-Distance Runners With Bone Stress Injuries?

Area of Science:

• Sports Medicine
• Orthopedics
• Radiology

Background:

• Bone stress injuries (BSIs) are common in long-distance runners.
• Bone mineral density (BMD) Z scores are often used to assess bone health.
• Trabecular bone score (TBS) Z scores provide additional information about bone microarchitecture.

Purpose of the Study:

• To evaluate trabecular bone score (TBS) Z scores in long-distance runners with bone stress injuries (BSIs) where bone mineral density (BMD) Z scores are greater than -1.0.
• To determine if abnormal TBS Z scores are more prevalent in BSIs affecting trabecular-rich sites compared to cortical-rich sites.

Main Methods:

• Retrospective cohort study of 44 long-distance runners (aged 18-40) with BSIs.
• Analysis of Z scores from dual-energy x-ray absorptiometry (DXA) scans for both BMD and TBS.
• BSIs were stratified into trabecular-rich and cortical-rich sites.

Main Results:

• 55% of runners had a BMD Z score > -1.0.
• Within this subgroup, 54% exhibited abnormal TBS Z scores.
• No significant difference in abnormal TBS Z scores was found between trabecular-rich and cortical-rich BSIs.

Conclusions:

• TBS Z scores may provide complementary information to BMD Z scores in long-distance runners with BSIs, especially when BMD Z scores are above -1.0.
• Further research is necessary to fully validate the utility of TBS Z scores in this population.