Metacarpal cortical thickness by computed radiography in osteoporosis

Computed radiography was used to make radiogrammetric measurements of the second metacarpal in 240 women, 180 considered normal and 60 osteoporotic. These measurements had a coefficient of variation for the external diameter of 0.74% in normal women and 0.75% in osteoporotic women, and for the internal diameter of 2.4% and 2.03%, respectively. The group of women with osteoporosis was divided according to external diameter and internal diameter into a group with osteoporosis due to increased bone resorption (61.1%, normal external diameter and increased internal diameter), and osteoporosis due to deficient bone formation (26.1%, decreased external diameter and normal internal diameter). In the remaining subjects (12.8%), osteoporosis was attributed to both mechanisms. There was a significant linear regression between internal diameter and tartrate-resistant acid phosphatase concentration (p < 0.0001) in the group of increased bone resorption, which was absent (p = ns) in the group with deficient bone mass formation. No changes were observed in the size of the two groups. The low coefficient of variation of radiogrammetric measurements with computed radiography validate it as an accurate technique for bone mass studies. Moreover, it has the additional advantage of permitting determination of the proportion of women with osteoporosis due to increased bone resorption and/or deficient bone mass formation.