Deficits in Bone Architecture and Strength in Children Living With HIV on Antiretroviral Therapy

Background: Reduced bone mineral mass by dual x-ray absorptiometry is reported in children living with HIV (CLWH), but few studies of bone microarchitecture, particularly in sub-Saharan Africa, have been conducted. Here, we compare bone architecture and strength in black South African CLWH and uninfected control children by peripheral quantitative computed tomography (pQCT). Setting and Methods: One hundred seventy-two CLWH on antiretroviral therapy (ART) and 98 controls in the CHANGES Bone Study in Johannesburg, South Africa received pQCT scans of the radius and tibia. Measurements included trabecular and cortical volumetric bone mineral density (vBMD) and bone strength, estimated by the polar strength strain index (SSI), a validated measure of fracture risk. Results: CLWH (51% boys) and controls (63% boys) were an average of age 10.4 years. Mean ART duration for CLWH was 9.5 years, with 70.9% on an efavirenz-based, 28.5% on a lopinavir/ritonavir-based, and 1 child on an atazanavir/ritonavir-based regimen. Male CLWH had lower trabecular vBMD at the radius than controls after adjustment for age, radial length, and Tanner stage (β = −17.3, standard error = 7.2, P = 0.018). Bone strength by polar SSI was lower in CLWH than controls (778 vs. 972 mm3, P
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research

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AbstractThe surgeon general of the USA defines osteoporosis as “a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture.” Measuring bone strength,Biomechanical Computed Tomography analysis  (BCT), namely, finite element analysis of a patient’s clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied “opportunistically” to most existing CT scans that include the spine or hip re...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
CONCLUSION: Recommendations were sent to the authorities of AEC-ROC to implement actions that could reduce doses at these high-dose locations to meet the ALARA principle. PMID: 32364147 [PubMed - as supplied by publisher]
Source: Technology and Health Care - Category: Medical Devices Authors: Tags: Technol Health Care Source Type: research
AbstractPurpose of ReviewThis review discusses imaging modalities for fracture repair assessment, with an emphasis on pragmatic clinical and translational use, best practices for implementation, and challenges and opportunities for continuing research.Recent FindingsSemiquantitative radiographic union scoring remains the clinical gold standard, but has questionable reliability as a surrogate indicator of structural bone healing, particularly in early-stage, complex, or compromised healing scenarios. Alternatively, computed tomography (CT) scanning enables quantitative assessment of callus morphometry and mechanics through ...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research
Study Design. Retrospective analysis. Objective. To investigate the prevalence of osteoporosis (OP) in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD). Summary of Background Data. OP is related to many complications after lumbar fusion for patients with LDD. There are sparse data on the prevalence of OP among this specific population. Moreover, LDD can falsely elevate the bone mineral density measured by dual energy x-ray absorptiometry (DXA), leading to unreliable diagnostic results. Computed tomography (CT) Hounsfield unit (HU) values can help identify osteoporotic patients undetected by ...
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
This study aimed to determine the relationship of PMI to clinical parameters including bone mineral density (BMD) in candidates for lung transplantation.MethodsA retrospective review of transplant candidates at a single center was performed. Demographic, anthropomorphic, and clinical data were recorded. Pectoralis muscle area (PMA) was determined on an axial slice from a chest CT. PMI was calculated as the PMA divided by height squared. BMD was obtained from routine dual-energy X-ray absorptiometry (DXA) scan.ResultsIn 226 included patients, mean PMI was 8.2  ± 3.0 cm2/m2 in males and 6.1  ...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractSummaryWe performed a prospective study using both FRAX and computed tomography to screen for osteoporosis in men undergoing radiation for prostate cancer. We found that implementing routine computed tomography (CT)-based screening was feasible in the setting of a prospective study, but the yield of osteoporosis identification was low in this population.PurposeMen with prostate cancer (PCa) are at increased risk of hip fracture for multiple reasons. Estimation of hip fracture risk with the FRAX tool is currently recommended, but FRAX alone may not identify a portion of men with osteoporosis. We hypothesized that ad...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
The objective of this study to determine the correlation between Hounsfield unit (HU) measurements from the C4 vertebral body and dual-energy x-ray absorptiometry (DXA) T-score. Summary of Background Data: Recent attention has turned to the utilization of HU measurements from computed tomography (CT) as a potential screening method for low bone mineral density (BMD). We hypothesized that cervical spine CT HU measurements will correlate with BMD measurements conducted with DXA scans of the femoral neck. Material and Methods: Patients with cervical CT and femoral neck DXA scans at 1 institution were included in the stu...
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
Hart, NH, Newton, RU, Weber, J, Spiteri, T, Rantalainen, T, Dobbin, M, Chivers, P, and Nimphius, S. Functional basis of asymmetrical lower-body skeletal morphology in elite Australian footballers. J Strength Cond Res 34(3): 791–799, 2020—Bone strength is a product of its material and structural properties and is highly responsive to mechanical load. Given the measureable and adaptable features of bone, and thus relevance to medical screening, injury prevention, and injury management in athletes, this study describes the lower-body skeletal morphology of professional Australian rules footballers. Using a cross-s...
Source: Journal of Strength and Conditioning Research - Category: Sports Medicine Tags: Original Research Source Type: research
AbstractSummaryLumbar spine volumetric bone mineral density (BMD) measured using quantitative computed tomography (QCT) can discriminate between postmenopausal women with low areal BMD with and without vertebral fractures. QCT provides a 3D measure of BMD, excludes the vertebral posterior elements and accounts for bone size. This knowledge could contribute to effective treatment targeting of patients with low BMD.IntroductionWe evaluated the ability of lumbar spine bone mineral apparent density (BMAD), trabecular bone score (TBS) and volumetric bone mineral density (vBMD) to discriminate between postmenopausal women with l...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Patients at risk for osteoporotic fractures can be identified through their...Read more on AuntMinnie.comRelated Reading: AI accurately detects vertebral fractures on CT AAOS: QCT finds low bone density in lumbar fusion patients 3D DEXA enhances hip fracture risk prediction USPSTF reaffirms osteoporosis screening Vertebral CAD aces detection of compression fractures
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
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