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. 1989 Jan;83(1):168–174. doi: 10.1172/JCI113854

Unequal decrease in bone density of lumbar spine and ultradistal radius in Colles' and vertebral fracture syndromes.

R Eastell 1, H W Wahner 1, W M O'Fallon 1, P C Amadio 1, L J Melton 3rd 1, B L Riggs 1
PMCID: PMC303657  PMID: 2910906

Abstract

We measured bone mineral density (BMD) at the lumbar spine (LS-BMD) and ultradistal radius (UDR-BMD) in 42 postmenopausal normal women and in 108 postmenopausal osteoporotic women (55 with vertebral fracture, 34 with Colles' fracture, and 19 with both fractures). By receiver operating characteristic analysis, LS-BMD was better than UDR-BMD (P less than 0.01) as an indicator of vertebral fracture; the converse was true for Colles' fracture (P less than 0.01). Although UDR-BMD and LS-BMD were lower in each of the three fracture groups than in controls (P less than 0.01), the pattern of bone loss differed (P less than 0.001, analysis of variance): with vertebral fracture, LS-BMD decreased relatively more than UDR-BMD; with Colles' fracture, UDR-BMD decreased relatively more than LS-BMD; and with both fractures, decreases in LS-BMD and UDR-BMD were similar. We conclude that both types of fracture are caused by excessive bone loss but the difference in bone loss at the two sites is a major factor in determining which will fracture.

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Selected References

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  1. Awbrey B. J., Jacobson P. C., Grubb S. A., McCartney W. H., Vincent L. M., Talmage R. V. Bone density in women: a modified procedure for measurement of distal radial density. J Orthop Res. 1984;2(4):314–321. doi: 10.1002/jor.1100020402. [DOI] [PubMed] [Google Scholar]
  2. Crilly R. G., Delaquerrière Richardson L., Roth J. H., Vandervoort A. A., Hayes K. C., Mackenzie R. A. Postural stability and Colles' fracture. Age Ageing. 1987 May;16(3):133–138. doi: 10.1093/ageing/16.3.133. [DOI] [PubMed] [Google Scholar]
  3. Hangartner T. N., Overton T. R. Quantitative measurement of bone density using gamma-ray computed tomography. J Comput Assist Tomogr. 1982 Dec;6(6):1156–1162. doi: 10.1097/00004728-198212000-00017. [DOI] [PubMed] [Google Scholar]
  4. Hanley J. A., McNeil B. J. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology. 1983 Sep;148(3):839–843. doi: 10.1148/radiology.148.3.6878708. [DOI] [PubMed] [Google Scholar]
  5. Hanley J. A., McNeil B. J. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982 Apr;143(1):29–36. doi: 10.1148/radiology.143.1.7063747. [DOI] [PubMed] [Google Scholar]
  6. Hesp R., Klenerman L., Page L. Decreased radial bone mass in Colles' fracture. Acta Orthop Scand. 1984 Oct;55(5):573–575. doi: 10.3109/17453678408992964. [DOI] [PubMed] [Google Scholar]
  7. Härmä M., Karjalainen P. Trabecular osteopenia in Colles' fracture. Acta Orthop Scand. 1986 Feb;57(1):38–40. doi: 10.3109/17453678608993212. [DOI] [PubMed] [Google Scholar]
  8. Jensen G. F., Christiansen C., Boesen J., Hegedüs V., Transbøl I. Relationship between bone mineral content and frequency of postmenopausal fractures. Acta Med Scand. 1983;213(1):61–63. doi: 10.1111/j.0954-6820.1983.tb03691.x. [DOI] [PubMed] [Google Scholar]
  9. Karjalainen P. A method for determination of the mineral content and mineral density of the distal radius using gamma ray attenuation. Ann Clin Res. 1973 Aug;5(4):231–237. [PubMed] [Google Scholar]
  10. Krølner B., Tøndevold E., Toft B., Berthelsen B., Nielsen S. P. Bone mass of the axial and the appendicular skeleton in women with Colles' fracture: its relation to physical activity. Clin Physiol. 1982 Apr;2(2):147–157. doi: 10.1111/j.1475-097x.1982.tb00017.x. [DOI] [PubMed] [Google Scholar]
  11. Mazess R. B. Diagnostic sensitivity of bone densitometry. J Bone Miner Res. 1988 Feb;3(1):121–123. doi: 10.1002/jbmr.5650030119. [DOI] [PubMed] [Google Scholar]
  12. Nilas L., Borg J., Gotfredsen A., Christiansen C. Comparison of single- and dual-photon absorptiometry in postmenopausal bone mineral loss. J Nucl Med. 1985 Nov;26(11):1257–1262. [PubMed] [Google Scholar]
  13. Nilas L., Nørgaard H., Pødenphant J., Gotfredsen A., Christiansen C. Bone composition in the distal forearm. Scand J Clin Lab Invest. 1987 Feb;47(1):41–46. [PubMed] [Google Scholar]
  14. Nilas L., Pødenphant J., Riis B. J., Gotfredsen A., Christiansen C. Usefulness of regional bone measurements in patients with osteoporotic fractures of the spine and distal forearm. J Nucl Med. 1987 Jun;28(6):960–965. [PubMed] [Google Scholar]
  15. Nillson B. E., Westlin N. E. The bone mineral content in the forearm of women with colles' fracture. Acta Orthop Scand. 1974;45(6):836–844. doi: 10.3109/17453677408989694. [DOI] [PubMed] [Google Scholar]
  16. Nottestad S. Y., Baumel J. J., Kimmel D. B., Recker R. R., Heaney R. P. The proportion of trabecular bone in human vertebrae. J Bone Miner Res. 1987 Jun;2(3):221–229. doi: 10.1002/jbmr.5650020309. [DOI] [PubMed] [Google Scholar]
  17. Ott S. M., Kilcoyne R. F., Chesnut C. H., 3rd Ability of four different techniques of measuring bone mass to diagnose vertebral fractures in postmenopausal women. J Bone Miner Res. 1987 Jun;2(3):201–210. doi: 10.1002/jbmr.5650020306. [DOI] [PubMed] [Google Scholar]
  18. Pesch H. J., Scharf H. P., Lauer G., Seibold H. Der altersabhängige Verbundbau der Lendenwirbelkörper. Eine Struktur- und Formanalyse. Virchows Arch A Pathol Anat Histol. 1980;386(1):21–41. doi: 10.1007/BF00432642. [DOI] [PubMed] [Google Scholar]
  19. Pøodenphant J., Nielsen V. A., Riis B. J., Gotfredsen A., Christiansen C. Bone mass, bone structure and vertebral fractures in osteoporotic patients. Bone. 1987;8(3):127–130. doi: 10.1016/8756-3282(87)90010-x. [DOI] [PubMed] [Google Scholar]
  20. Riggs B. L., Melton L. J., 3rd Evidence for two distinct syndromes of involutional osteoporosis. Am J Med. 1983 Dec;75(6):899–901. doi: 10.1016/0002-9343(83)90860-4. [DOI] [PubMed] [Google Scholar]
  21. Riggs B. L., Melton L. J., 3rd Involutional osteoporosis. N Engl J Med. 1986 Jun 26;314(26):1676–1686. doi: 10.1056/NEJM198606263142605. [DOI] [PubMed] [Google Scholar]
  22. Riggs B. L., Wahner H. W., Dunn W. L., Mazess R. B., Offord K. P., Melton L. J., 3rd Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest. 1981 Feb;67(2):328–335. doi: 10.1172/JCI110039. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rüegsegger P., Anliker M., Dambacher M. Quantification of trabecular bone with low dose computed tomography. J Comput Assist Tomogr. 1981 Jun;5(3):384–390. doi: 10.1097/00004728-198106000-00014. [DOI] [PubMed] [Google Scholar]
  24. Schlenker R. A., VonSeggen W. W. The distribution of cortical and trabecular bone mass along the lengths of the radius and ulna and the implications for in vivo bone mass measurements. Calcif Tissue Res. 1976 Apr 13;20(1):41–52. doi: 10.1007/BF02546396. [DOI] [PubMed] [Google Scholar]
  25. Wahner H. W., Riggs B. L., Beabout J. W. Diagnosis of osteoporosis: usefulness of photon absorptiometry at the radius. J Nucl Med. 1977 May;18(5):432–437. [PubMed] [Google Scholar]

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