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Age dependance of vertebral deformity, by use of radiographic morphometry
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BONE MINERAL DENSITY IN HEALTHY CHILDREN AND IN OSTEOGENESIS IMPERFECTA Robert Jones and Agnes Hunt Hospital, Oswestry. Shropshire, U.Kr Bone mineral densitoinetry (BMD) provides additional data for diagnosing and managing growth and metabolic bone disorders. We report BMD measurements in Lumbar spine (LS) and Ward’s triangle(WT) in a group of healthy children and in subjects with osteogenesis imperfecta (01). BMD measurements (glcrn2) (Hologic 0DRlOOO) were made in 62 female (513yr) and 59 male (613yr) healthy Caucasian children and 7 (6f.l m) subjects wilh 01 (Type 2) aged 5-l 3 yr . Mean LS BMD (standard deviation,SD) in girls was O.SS(O.03) at 6yr, 0.58(0.05) at Qyr and increased to 0.83(0.12) at 13yr. In boys LS BMD at equivalent ages was 0.57(0.04). 0.62(0.09) and 0.70(0.08) and was significantly lower tian in girls at 1 lyr (pCa.05) and 12 yr(p
AGE DEPENDANCE OP VERTEBRAL DEFORMITY, BY USE OF RADIOGRAPHIC MORPHOMETRY. m Charles Salt Centre, and Department of Diagnostic Imaging*, Robert Jones and Agnes Hunt Orlhopaedic Hospital, Oswestty, Shropshira, U.K.. The variation of the shapeoitheverlebral body with age and vertebral level has been investigated in over 900 women (age SO-61 years, mean 64.6 lt7.2 years) recruited fmm primary care physictan services, and the incidence of deformity detemrined using different criteria. Vertebral morphometry was pedonned using computerised image analysis of lateral radiographs from Db trl L4. For each vertebra indices of wedging (WI - reduction in anterior height). bfconcavity (BCl - reduction in mid-height), specilic compression (SCI - reduction in ratio of posterior height to inferior antero- postedor distance), and relative compression (RCI - posterior height compared with adjacent vertebra) were determined. The mean values of fhese indices varied with vertebral level. BC! *vas greatest at D7(12.6%) and Ll(l3.1%). SCI and RCI had maxima at DQ(27.7) and D12(6.9) and minima at Ll(Q.0) and L3(0.2) respectively. WI had a maximum at D7(13.2) and minimum at D4(6.3). Between age 60 and 75yr SCI increased significantly at levels D7 to DlO @
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323 OSTEOPOR&lS AND FRACTURES AFTER CARDIAC TRANSPLANTATION. E. Shane. S.J. Silverbero. T. Kim. M. del 6 . . Rivas. R.B. m J.P. B&&&t College of Physicians & Surgeons, Columbie U.. New York, U.S.A. Cardiac transplantation (CTX) requires the use of certain immunosuppressive agents (glucocorticoids and cyclosporine AI that are known to affect bone metabolism. Preliminary data suQgest that osteoporotic fractures constitute a major cause of morbidity in patients after CTX. We measured Indices of mineral metabolism (MM1 and bone mineral density (BMD) and examined spine radiographs in 40 CTX patients treated with dally cyclosporine A (460235 me1 and orednisone f9.7AO.7 mol. The nrouo consisted of 10 women (W) age 53~4 fme&@Mf, 24~5 months after CTX and 30 men (MI age 53~2, 29&4 months after CTX. Osteocalcin levels were elevated in 60% of CT?? patients (mean 11.6~1.4 nglmll unlike other patients on glucocorticoids. Vertebral fractures were present in 35% of the oatients. Eleven (28%) patients (3W; BM) had vertebral osteopenia (2 score & 2.0). 0steopenic patients were younger (4023 vs 57~2: pcO.001 I, longer post CTX (42 +7 vs 23~3 mos.; ~~0.011. had received more cumulative pred&ne (14.9k2.2 vs lO.l_d.2 g; p
VERTEBRAL DEFORMITY AND BONE MINERAL DENSITY. P.H.F.Nav*. M.WJJ&& Charles Salt Centre, and Department of Diagnostic Imaging*, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, U.K.. We have investigated geometric indices quantifying deformity of the vertebral body in a population-based group of 223 female subjects aged 50-61 years (mean 63 years), and compared Bone Mineral Density (BMD) of those with “significant” vertebral deformily to those without. Vertebral rnorphometry was performed on lateral radiographs of the dorsal and lumbar spine. Lumbar spine BMD was measured using Dual Energy X-ray Absorptiometry (Hologic QDRlOOO). Body height and weight were recorded. Body height correlated with average vertebral area, and average posterior vertebral height (m0.641, rr0.671 respectively). Body weight showed similar correlations. For each vertebra, wedging, biconcavity, and compresslon were quantified using appropriate Indices. The mean values of these indices were found to vary with vertebral level, By defining a “slgnilicant” deformity as a value of any of these indices grealer than the mean + 3 standard deviations (sd.) at each level, the incidence of dsfocmity was determined. This 3 s.d. criterion identified 27 subfects (12%) as havirlg one or more deformities of any type. Mean BMD was lower In this group but this difference was not significant (at p=O.O+L\ Only subjects wilh biconcave deformity had a significantly reduced EMD (pcO.01). Mean age of subjectswith biconcavedeformities wasnotsignificanllydifferenttothose without. We conclude thatonly biconcave deformity is significantly associated with low BMD. The presence of wedge and compression deformities in subjects wilh normal BMD suggests an allernalive process affecting vertebral shape independently of bone mineral status.
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BONE MINERAL DENSITY IN HEALTHY CHILDREN AND IN OSTEOGENESIS IMPERFECTA Robert Jones and Agnes Hunt Hospital, Oswestry. Shropshire, U.Kr Bone mineral densitoinetry (BMD) provides additional data for diagnosing and managing growth and metabolic bone disorders. We report BMD measurements in Lumbar spine (LS) and Ward’s triangle(WT) in a group of healthy children and in subjects with osteogenesis imperfecta (01). BMD measurements (glcrn2) (Hologic 0DRlOOO) were made in 62 female (513yr) and 59 male (613yr) healthy Caucasian children and 7 (6f.l m) subjects wilh 01 (Type 2) aged 5-l 3 yr . Mean LS BMD (standard deviation,SD) in girls was O.SS(O.03) at 6yr, 0.58(0.05) at Qyr and increased to 0.83(0.12) at 13yr. In boys LS BMD at equivalent ages was 0.57(0.04). 0.62(0.09) and 0.70(0.08) and was significantly lower tian in girls at 1 lyr (pCa.05) and 12 yr(p
AGE DEPENDANCE OP VERTEBRAL DEFORMITY, BY USE OF RADIOGRAPHIC MORPHOMETRY. m Charles Salt Centre, and Department of Diagnostic Imaging*, Robert Jones and Agnes Hunt Orlhopaedic Hospital, Oswestty, Shropshira, U.K.. The variation of the shapeoitheverlebral body with age and vertebral level has been investigated in over 900 women (age SO-61 years, mean 64.6 lt7.2 years) recruited fmm primary care physictan services, and the incidence of deformity detemrined using different criteria. Vertebral morphometry was pedonned using computerised image analysis of lateral radiographs from Db trl L4. For each vertebra indices of wedging (WI - reduction in anterior height). bfconcavity (BCl - reduction in mid-height), specilic compression (SCI - reduction in ratio of posterior height to inferior antero- postedor distance), and relative compression (RCI - posterior height compared with adjacent vertebra) were determined. The mean values of fhese indices varied with vertebral level. BC! *vas greatest at D7(12.6%) and Ll(l3.1%). SCI and RCI had maxima at DQ(27.7) and D12(6.9) and minima at Ll(Q.0) and L3(0.2) respectively. WI had a maximum at D7(13.2) and minimum at D4(6.3). Between age 60 and 75yr SCI increased significantly at levels D7 to DlO @
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323 OSTEOPOR&lS AND FRACTURES AFTER CARDIAC TRANSPLANTATION. E. Shane. S.J. Silverbero. T. Kim. M. del 6 . . Rivas. R.B. m J.P. B&&&t College of Physicians & Surgeons, Columbie U.. New York, U.S.A. Cardiac transplantation (CTX) requires the use of certain immunosuppressive agents (glucocorticoids and cyclosporine AI that are known to affect bone metabolism. Preliminary data suQgest that osteoporotic fractures constitute a major cause of morbidity in patients after CTX. We measured Indices of mineral metabolism (MM1 and bone mineral density (BMD) and examined spine radiographs in 40 CTX patients treated with dally cyclosporine A (460235 me1 and orednisone f9.7AO.7 mol. The nrouo consisted of 10 women (W) age 53~4 fme&@Mf, 24~5 months after CTX and 30 men (MI age 53~2, 29&4 months after CTX. Osteocalcin levels were elevated in 60% of CT?? patients (mean 11.6~1.4 nglmll unlike other patients on glucocorticoids. Vertebral fractures were present in 35% of the oatients. Eleven (28%) patients (3W; BM) had vertebral osteopenia (2 score & 2.0). 0steopenic patients were younger (4023 vs 57~2: pcO.001 I, longer post CTX (42 +7 vs 23~3 mos.; ~~0.011. had received more cumulative pred&ne (14.9k2.2 vs lO.l_d.2 g; p
VERTEBRAL DEFORMITY AND BONE MINERAL DENSITY. P.H.F.Nav*. M.WJJ&& Charles Salt Centre, and Department of Diagnostic Imaging*, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, U.K.. We have investigated geometric indices quantifying deformity of the vertebral body in a population-based group of 223 female subjects aged 50-61 years (mean 63 years), and compared Bone Mineral Density (BMD) of those with “significant” vertebral deformily to those without. Vertebral rnorphometry was performed on lateral radiographs of the dorsal and lumbar spine. Lumbar spine BMD was measured using Dual Energy X-ray Absorptiometry (Hologic QDRlOOO). Body height and weight were recorded. Body height correlated with average vertebral area, and average posterior vertebral height (m0.641, rr0.671 respectively). Body weight showed similar correlations. For each vertebra, wedging, biconcavity, and compresslon were quantified using appropriate Indices. The mean values of these indices were found to vary with vertebral level, By defining a “slgnilicant” deformity as a value of any of these indices grealer than the mean + 3 standard deviations (sd.) at each level, the incidence of dsfocmity was determined. This 3 s.d. criterion identified 27 subfects (12%) as havirlg one or more deformities of any type. Mean BMD was lower In this group but this difference was not significant (at p=O.O+L\ Only subjects wilh biconcave deformity had a significantly reduced EMD (pcO.01). Mean age of subjectswith biconcavedeformities wasnotsignificanllydifferenttothose without. We conclude thatonly biconcave deformity is significantly associated with low BMD. The presence of wedge and compression deformities in subjects wilh normal BMD suggests an allernalive process affecting vertebral shape independently of bone mineral status.
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