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Measurement of Distal Ulnar Hounsfield Units Accurately Predicts Bone Mineral Density of the Forearm.

Abstract Hounsfield unit (HU) measurement obtained from computed tomography (CT) scans of the wrist is a potential new screening method for low bone mineral density (BMD). We hypothesized that HU measurements of the ulnar head obtained from CT scans would correlate with BMD assessed with dual x-ray absorptiometry (DXA) scans of the forearm.
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Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 28419040
OWN - NLM
STAT- In-Process
DA  - 20170418
LR  - 20170418
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 8
DP  - 2017 Apr 19
TI  - Measurement of Distal Ulnar Hounsfield Units Accurately Predicts Bone Mineral
      Density of the Forearm.
PG  - e38
LID - 10.2106/JBJS.15.01244 [doi]
AB  - BACKGROUND: Hounsfield unit (HU) measurement obtained from computed tomography
      (CT) scans of the wrist is a potential new screening method for low bone mineral 
      density (BMD). We hypothesized that HU measurements of the ulnar head obtained
      from CT scans would correlate with BMD assessed with dual x-ray absorptiometry
      (DXA) scans of the forearm. METHODS: Patients with both upper-extremity CT and
      DXA scans performed at a single institution were included in the study.
      Hounsfield units were manually measured in the distal part of the ulna by 1
      author blinded to the DXA results. Average values were then compared with forearm
      BMD values as determined with a DXA scan. RESULTS: Seventy-seven CT scans of 74
      patients were included. Average HU values were significantly lower in the
      osteoporotic and osteopenic groups in comparison with the normal BMD group. The
      upper limit of the 95% confidence interval for osteopenic patients was 145.9 HU. 
      The average forearm T-score for patients with an HU value at or below the cutoff 
      of 146 was significantly lower than the average T-score for those with an HU
      value of >146 HU (p < 0.0001). Sensitivity and negative predictive value for low 
      BMD using this cutoff value were calculated to be 91% and 89%, respectively.
      CONCLUSIONS: Distal ulnar HU measurements accurately reflect the BMD of the
      forearm as diagnosed with a DXA scan. Our results suggest that distal ulnar HU
      measurements of </=146 HU are strongly associated with low BMD and that values
      above this cutoff accurately rule out low forearm BMD with a high degree of
      sensitivity and negative predictive value. Utilizing this technique may improve
      the capture of at-risk patients and streamline the screening process for
      osteoporosis. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for
      Authors for a complete description of levels of evidence.
FAU - Wagner, Scott C
AU  - Wagner SC
AD  - 1Department of Orthopaedics, Walter Reed National Military Medical Center,
      Bethesda, Maryland 2Department of Surgery, Uniformed Services University of the
      Health Sciences, Bethesda, Maryland 3Department of Orthopaedic Surgery,
      University of Pennsylvania Health System, Philadelphia, Pennsylvania.
FAU - Dworak, Theodora C
AU  - Dworak TC
FAU - Grimm, Patrick D
AU  - Grimm PD
FAU - Balazs, George C
AU  - Balazs GC
FAU - Tintle, Scott M
AU  - Tintle SM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
CRDT- 2017/04/19 06:00
AID - 10.2106/JBJS.15.01244 [doi]
AID - 00004623-201704190-00012 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Apr 19;99(8):e38. doi: 10.2106/JBJS.15.01244.

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