Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method

S Dudley-Javoroski; R K Shields

doi:10.1007/s00198-009-1044-5

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Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method

Journal article

Open access

Peer reviewed

Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method

S Dudley-Javoroski and R K Shields

Osteoporosis international, Vol.21(6), pp.985-995

06/2010

DOI: 10.1007/s00198-009-1044-5

PMCID: PMC2875776

PMID: 19707702

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Abstract

Surveillance of femur metaphysis bone mineral density (BMD) decline after spinal cord injury (SCI) may be subject to slice placement error of 2.5%. Adaptations to anti-osteoporosis measures should exceed this potential source of error. Image analysis parameters likewise affect BMD output and should be selected strategically in longitudinal studies. Understanding the longitudinal changes in bone mineral density (BMD) after spinal cord injury (SCI) is important when assessing new interventions. We determined the longitudinal effect of SCI on BMD of the femur metaphysis. To facilitate interpretation of longitudinal outcomes, we (1) determined the BMD difference associated with erroneous peripheral quantitative computed tomography (pQCT) slice placement, and (2) determined the effect of operator-selected pQCT peel algorithms on BMD. pQCT images were obtained from the femur metaphysis (12% of length from distal end) of adult subjects with and without SCI. Slice placement errors were simulated at 3 mm intervals and were processed in two ways (threshold-based vs. concentric peel). BMD demonstrated a rapid decline over 2 years post-injury. BMD differences attributable to operator-selected peel methods were large (17.3% for subjects with SCI). Femur metaphysis BMD declines after SCI in a manner similar to other anatomic sites. Concentric (percentage-based) peel methods may be most appropriate when special sensitivity is required to detect BMD adaptations. Threshold-based methods may be more appropriate when asymmetric adaptations are observed.

Bone Diseases, Metabolic - diagnostic imaging

Bone Density - physiology

Cross-Sectional Studies

Spinal Cord Injuries - complications

Humans

Middle Aged

Bone Diseases, Metabolic - etiology

Tomography, X-Ray Computed - methods

Male

Femur - diagnostic imaging

Image Processing, Computer-Assisted - methods

Femur - physiopathology

Disease Progression

Young Adult

Adolescent

Adult

Female

Spinal Cord Injuries - physiopathology

Bone Diseases, Metabolic - physiopathology

Longitudinal Studies

Details

Title: Subtitle: Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method
Creators: S Dudley-Javoroski - Graduate Program in Physical Therapy and Rehabilitation Science, The University of Iowa, 1-252 Medical Education Building, Iowa City, IA 52242-1190, USA
R K Shields
Resource Type: Journal article
Publication Details: Osteoporosis international, Vol.21(6), pp.985-995
DOI: 10.1007/s00198-009-1044-5
PMID: 19707702
PMCID: PMC2875776
NLM abbreviation: Osteoporos Int
ISSN: 0937-941X
eISSN: 1433-2965
Publisher: England
Grant note: R01 NR010285 / NINR NIH HHS R01 NR010285-05 / NINR NIH HHS R01 HD062507 / NICHD NIH HHS R01-NR 010285-05 / NINR NIH HHS
Language: English
Date published: 06/2010
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984047886302771

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