Findings highlight a significant association between BME-related conditions and altered BMD/TBS parameters, suggesting a potential shared pathophysiological link.
Abstract
Background: Bone Marrow Edema Syndrome (BMEs) encompasses primary clinical conditions characterized by pain and high-intensity signals on fluid-sensitive magnetic resonance imaging at the subchondral bone level. This study aimed to evaluate bone mineral density (BMD) and turnover markers in BMEs patients compared to a healthy control group. Methods: We selected from the records 165 patients—comprising Complex Regional Pain Syndrome type 1 (CRPS-1, n = 61), hip BMEs (n = 42), and knee BMEs (n = 62)—alongside 150 age- and sex-matched healthy controls. Assessments included bone turnover markers, vitamin D levels, and BMD at the lumbar spine and femur by Dual-Energy X-ray Absorptiometry. Trabecular Bone Score (TBS) was calculated to estimate bone microarchitecture. Results: BMEs patients demonstrated significantly lower BMD across all skeletal sites and reduced TBS values compared to controls. Osteoporosis prevalence was significantly higher in all BMEs subgroups, with CRPS-1 and hip BMES patients showing higher rates than those with knee BMEs. No significant differences were observed in vitamin D or bone turnover markers between groups. Conclusions: Patients with CRPS-1 and BMEs of the hip or knee exhibit a higher prevalence of osteoporosis and compromised bone microarchitecture. These findings highlight a significant association between BME-related conditions and altered BMD/TBS parameters, suggesting a potential shared pathophysiological link.
Assessment of bone mineral density (BMD), trabecular bone score (TBS), and muscle mass in adults with PIDs found reduced BMD and impaired TBS represented distinct, partially overlapping findings.
A. Nowakowska-Płaza, J. Wroński, A. Zegadło et al.· Frontiers in Endocrinology· 0 citations
The trabecular bone score (TBS) provides complementary, indirect information on trabecular microarchitecture that may be independently impaired in SSc, and SSc patients exhibit significantly impaired bone microarchitecture compared with matched controls.
Nipaporn Intarasattakul, C. Pongchaiyakul, C. Foocharoen et al.· Journal of clinical densitom...· 0 citations
The findings suggest that the clinical role of TBS in the assessment of pediatric bone health remains to be established, and that larger prospective studies are needed to clarify the clinical value of TBS for fracture risk assessment in pediatric autoimmune gastrointestinal diseases.
Anna Łupińska, Sara Aszkiełowicz, Arkadiusz Zygmunt et al.· Nutrients· 0 citations
Study Design Retrospective sex- and age-matched case-control study. Purpose To assess bone mineral density (BMD)–trabecular bone score (TBS) discordance and high-burden abdominal aortic calcification (AAC) in patients with radiographically confirmed osteoporotic vertebral compression fracture (OVCF). Overview of Literature Conventional BMD thresholds may fail to identify all patients with vertebral skeletal fragility, as vertebral fractures can occur despite nonosteoporotic BMD. TBS complements BMD by evaluating trabecular microarchitecture, while AAC may serve as a marker of systemic bone–vascular health associated with skeletal fragility. Methods This retrospective sex- and age-matched case-control study enrolled patients aged ≥50 years who underwent dual-energy X-ray absorptiometry (DXA) with TBS assessment and vertebral imaging. OVCF was defined as a Genant grade 2 or 3 vertebral fracture. The primary cohort included 47 OVCF patients and 188 matched controls. BMD T-scores at the lumbar spine, femoral neck, total hip, TBS, and AAC-24 were evaluated. Matched conditional logistic regression was used to determine associations with OVCF. Results More than half of OVCF patients did not demonstrate osteoporotic BMD at any measured DXA site (53.2%). Among those with nonosteoporotic BMD, low TBS was more common in cases than in controls (48.0% vs. 22.7%). Low TBS remained independently associated with OVCF after adjusting for the lowest BMD T-score and high-burden AAC (odds ratio, 2.66; 95% confidence interval, 1.25–5.63; p=0.011). High-burden AAC was more frequent among cases, although its association was attenuated after adjustment. Conclusions Low TBS may aid in identifying vertebral skeletal fragility in OVCF patients with nonosteoporotic BMD on conventional DXA. High-burden AAC may provide vascular information, although its incremental association beyond BMD and TBS was attenuated.
Introduction: Osteoporosis is a systemic skeletal disorder that increases the risk of fragility fracture and constitutes a major global health burden. Dual-Energy X-Ray Absorptiometry (DEXA) is the clinical reference standard for Bone Mineral Density (BMD) assessment but, as a two-dimensional projection technique, does not directly evaluate trabecular microarchitecture or marrow composition. Magnetic Resonance Imaging (MRI) signal characteristics of vertebral marrow have been proposed as opportunistic markers of Vertebral Bone Quality (VBQ).
Aim: To evaluate the correlation between lumbar spine MRI signal alterations (T1- and T2-weighted) and DEXA-derived BMD parameters, including BMD, T-score and Z-score, in patients undergoing lumbar spine imaging.
Materials and Methods: A cross-sectional analytical study was conducted at Assam Down Town University, Guwahati, Assam, India, from October 2023 to April 2024. A total of 100 adults of either sex who underwent both lumbar spine MRI (1.5 Tesla) and DEXA were evaluated. A circular Region Of Interest (ROI) of 1 cm² was placed in the central trabecular portion of the L3 vertebral body on T1- and T2- weighted sagittal images, avoiding cortical bone, end-plate changes and focal lesions. DEXA-derived BMD was classified according to World Health Organisation (WHO) T-score criteria. Pearson’s correlation coefficient with 95% Confidence Intervals (CI) was used to assess associations; a two-tailed p-value <0.05 was considered significant.
Results: The cohort comprised 52 females (52%) and 48 males (48%). Based on lumbar (L1-L4) T-scores, 42 (42%) participants had normal BMD, 31 (31%) osteopenia and 27 (27%) osteoporosis. Reduced BMD was more frequent among females and older participants. The T-score showed weak but statistically significant negative correlations with T1-weighted (r=-0.214; 95% CI -0.394 to -0.018; p-value=0.033) and T2- weighted (r=-0.208; 95% CI -0.389 to -0.012; p-value=0.038) signal values. The Z-score correlated strongly with mean BMD (r=0.685; 95% CI 0.565 to 0.777; p-value <0.001); as the Z-score is derived from BMD, this served as an internal consistency check.
Conclusion: Lumbar vertebral MRI signal alterations showed weak but statistically significant associations with DEXAderived BMD, suggesting that routinely acquired lumbar MRI may provide supplementary, opportunistic information on VBQ. The modest strength of these correlations indicates that MRI signal cannot currently replace DEXA for the diagnosis of osteoporosis.
Amit Sarma, Mrinal Singha· Journal of Clinical and Diag...· 0 citations
Objective To evaluate bone density and microstructure, fragility fractures, and hormones in men 50 years and older receiving antiseizure medications (ASMs). Subjects and methods Study population included 39 men with difficult-to-control epilepsy and 42 healthy men as control group. Spine and hip areal bone mineral density (aBMD), body composition and vertebral fracture assessment (VFA) were evaluated using Dual-Energy X-Ray Absorptiometry (DXA). Volumetric bone mineral density (vBMD) and microarchitecture of trabecular and cortical compartments were evaluated using High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT). Physical activity was tested by the International Physical Activity Questionnaire (IPAQ). The fracture risk was estimated by fracture risk assessment tool (FRAX). Results ASMs patients showed lower cortical bone thickness (Ct.Th) in distal tibia (1.196 ± 0.295 vs. 1.341 ± 0.241 mm, p = 0.03), more fractures (12 vs. 2, p = 0.003) mostly morphometric vertebral fractures, and a higher risk for major and hip fractures based on FRAX. Hormonal changes included higher median parathyroid hormone (PTH) (50.4 vs. 24 pg/mL, p < 0.001) possibly associated with vitamin D insufficiency, (25(OH)D levels below 30 ng/mL in 43.6% of ASMs patients), lower median Estradiol that was an independent factor for fractures (p = 0.04) and bioavailable Testosterone in the lowest quartile in 52 % of them. Conclusion Men on ASMs exhibit lower Ct.Th and hormone changes that may contribute to bone fragility. While clinical fractures are infrequent, it is crucial to actively search for morphometric fractures, either during DXA or through the more available method of spine X-rays.
Cristian Pieper, L. Vieira, Eduardo Ferreira da Gama et al.· Archives of Endocrinology an...· 0 citations
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