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Updated: May 16, 2025
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Total radius BMD correlates with the hip and lumbar spine BMD among post-menopausal patients with fragility wrist
Tapio Ruotsalainen1, Egor Panfilov2, Jerome Thevenot2
1Division of Musculoskeletal Surgery, University Hospital of Oulu, Oulu, Finland. tappijo@gmail.com.
Abstract:
Osteoporosis screening should be systematic in the group of over 50-year-old females with a radius fracture. We tested a phantom combined with machine learning model and studied osteoporosis-related variables. This machine learning model for screening osteoporosis using plain radiographs requires further investigation in larger cohorts to assess its potential as a replacement for DXA measurements in settings where DXA is not available.
Purpose:
The main purpose of this study was to improve osteoporosis screening, especially in post-menopausal patients with fragility wrist fractures. The secondary objective was to increase understanding of the connection between osteoporosis and aging, as well as other risk factors.
Methods:
We collected data on 83 females > 50 years old with a distal radius fracture treated at Oulu University Hospital in 2019-2020. The data included basic patient information, WHO FRAX tool, blood tests, X-ray imaging of the fractured wrist, and DXA scanning of the non-fractured forearm, both hips, and the lumbar spine. Machine learning was used in combination with a custom phantom.
Results:
Eighty-five percent of the study population had osteopenia or osteoporosis. Only 28.4% of patients had increased bone resorption activity measured by ICTP values. Total radius BMD correlated with other osteoporosis-related variables (age r = - 0.494, BMI r = 0.273, FRAX osteoporotic fracture risk r = - 0.419, FRAX hip fracture risk r = - 0.433, hip BMD r = 0.435, and lumbar spine BMD r = 0.645), but the ultra distal (UD) radius BMD did not. Our custom phantom combined with a machine learning model showed potential for screening osteoporosis, with the class-wise accuracies for "Osteoporotic vs. osteopenic & normal bone" of 76% and 75%, respectively.
Conclusion:
We suggest osteoporosis screening for all females over 50 years old with wrist fractures. We found that the total radius BMD correlates with the central BMD. Due to the limited sample size in the phantom and machine learning parts of the study, further research is needed to make a clinically useful tool for screening osteoporosis.
