Bone Quality What Is It and Can we Measure it

Bone Quality: What is it and can we measure it?

Mohammad Hossein Dabbaghmanesh

Professor of internal medicine

Shiraz Endocrine and Metabolism Research Center

Focusing Only on Bone Identifies Less than Half of Women Who Will Fracture

21. A relevant number of fragility fractures occur in the range of normal or slightly reduced BMD values meaning that also qualitative aspects of bone, like bone architecture and bone geometry, play a role .
21. Only 44% of women (and 21% of men) who sustain non-vertebral fractures have “osteoporosis "by BMD

Bone quality

21. Bone quality is generally defined as a collection of properties that contribute to fracture risk in addition to bone mineral density (BMD).

Methods for investigating bone quality

21. . Methods for investigating bone quality in vivo are being developed:
21. –– DXA: geometry, trabecular bone score
21. –– HRQCT: microarchitecture, cortical bone including porosity
21. –– MRI: microarchitecture
21. –– Quantitative ultrasound: cortical thickness, stiffness of bone
21. –– Digital x-ray radiogrammetry: cortical porosity
21. –– Microindentation: hardness of bone

DXA: geometry, trabecular bone score

21. New DXA tools recently developed, namely trabecular bone score (TBS) and hip structural analysis (HSA), obtained during DXA, can supply in formations about bone structure of spine and femur, respectively, in a not invasive way.
21. The first cited new DXA tools is the trabecular bone score (TBS), a gray-level textural measure that can be extracted from the 2-dimensional lumbar spine DXA image to estimate trabecular microstructure.