The added value of distal radius bone mineral density for the diagnosis of osteoporosis in patients with a history of fragility fracture.

BACKGROUND

Preventing osteoporotic fragility fractures is a critical health priority, yet there is limited data on the utility of distal radius bone mineral density (‎BMD) for this purpose. This study aimed to evaluate the added value of distal radius BMD in osteoporosis diagnosis in patients with a history of fragility fractures.

METHODS

In a retrospective analysis of prospectively collected data, 1205 who were enrolled in the Fracture Liaison Service of our institute were included in the analysis. The main outcome was the BMD classification of ‎patients using a 3-region BMD (femoral neck, lumbar spine, and distal radius) compared to the conventional 2-region BMD (femoral neck and lumbar spine). The lowest T-score from ‎any skeletal site was used to classify patients into normal, osteopenia, or ‎osteoporosis categories.‎.

RESULTS

Using a 2-region BMD, normal, osteopenia, and osteoporosis were identified in 11.1%, 42.7%, and 46.2% of patients, respectively. After adding distal radius BMD, normal, osteopenia and osteoporosis were detected in 5.6%, 32.9%, and 61.6% of patients, respectively. Two-region and 3-region BMD were discordant in 185 patients. A significant moderate correlation was found between the distal radius T-score and both the lumbar spine T-score (r = 0.470, P < 0.001) and the femoral neck T-score (r = 0.528, P < 0.001).

CONCLUSION

The addition of distal radius densitometry to the conventional BMD regions can result in an earlier diagnosis of osteoporosis in patients with a high risk of fragility fracture. Consequently, it has the potential to be integrated into future osteoporosis classification systems.