The value of peripheral quantitative computed tomography (pQCT) in the diagnosis of osteoporosis

Aim: To evaluate the accuracy of distal radial pQCr in discriminating between osteoporotic fracture and non fracture cases and its efficiency to predict fractures. Methods: Densitometric data determined with an XCT 900 Stratec pQCT device at the distal radius of women who had suffered distal radius (57), spinal (87) or femoral neck fractures (21) before or after measurement were compared with densitometric datas of age-matched healthy women (265) and were analyzed in regression tests. Women whose fractures occurred before measuring were selectively analyzed. Results: More significant differences between fracture and non fracture groups were obtained by trabecular bone density (TBD) (r(radius)(2) = 0.531, r(spine)(2) = 0.528, r(femur)(2) =0.711, p<0.001) than by total bone density (BD) (r(radius)(2) = 0.468, r(spine)(2) = 0.495, r(femur)(2) = 0.605, p<0.001). in the radius and spine group TBD data determined before fracture showed less significant differences than those determined afterwards, whereas in the femur group TBD data were almost equal. All femur fractures could be predicted. As TBD decreased, the relative risk of fracture increased by gradients of m(radius) = 0.017, m(spine) = 0.013, and m(femur) = 0.027 in the linear regions of the risk curves. Conclusion: Selective measuring of TBD at the distal radius enables one to detect bone loss at an early stage and to estimate the risk of future fractures not only at the point of measurement.