R L Duckham1,2, S R Bialo3, J Machan4, P Kriz5, C M Gordon6. 1. Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia. 2. Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia. 3. Division of Pediatric Endocrinology, Rhode Island Hospital/Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA. 4. Division of Biostatistics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA. 5. Division of Sports Medicine, Departments of Orthopedics and Pediatrics, Warren Alpert Medical School Rhode Island Hospital/Hasbro Children's Hospital, Brown University, Providence, RI, USA. 6. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA. catherine.gordon@childrens.harvard.edu.
Abstract
Since stress fractures are common among adolescent athletes, it is important to identify bone assessment tools that accurately identify risk. We investigated the discriminative ability of two imaging technologies to classify at-risk athletes. Findings suggested that peripheral quantitative computed tomography (pQCT) has the ability to distinguish differences in bone structure in injured vs. uninjured limbs. INTRODUCTION: Given the high stress fracture (SFX) prevalence among adolescent girls, an understanding of the most informative assessment tools to identify SFX risks are required. We investigated the discriminative ability of pQCT vs. dual-energy X-ray absorptiometry (DXA) to classify athletes with or without SFX. METHODS: Twelve adolescent athletes diagnosed with a lower-extremity SFX were compared with 12 matched controls. DXA measured areal bone mineral density (aBMD) and content of the total body, and lumbar spine. Bilateral tibiae were assessed with pQCT. At the metaphysis (3%), total density (ToD), trabecular density (TrD), trabecular area (TrA), and estimated bone strength in compression (BSIc), and at the diaphysis (38% and 66%), total bone area (ToA), cortical density (CoD), cortical area (CoA), estimated bone strength in torsion (SSIp), and peri- and endocortical and muscle area (MuA) were obtained. Cortical bone mass/density around the center of mass and marrow density (estimate of adiposity) were calculated using ImageJ software. General estimated equations adjusting for multiple comparisons (Holm-Bonferroni method) were used to compare means between (1) injured limb of the case athletes vs. uninjured limb of the control athletes and (2) uninjured limb of the case athletes vs. uninjured limbs of the controls and injured vs. uninjured limb of case athletes with a SFX. RESULTS: aBMD and content showed no significant differences between cases and controls. When comparing the injured vs. uninjured leg in the case athletes by pQCT at the 3% tibia, unadjusted TrD, total density, and BSIc were significantly lower (p < 0.05) in the injured vs. uninjured leg. Marrow density at the 66% site was 1% (p < 0.05) lower in the injured vs. uninjured leg. CONCLUSIONS: These preliminary data in athletes with SFX suggest that pQCT has the ability to distinguish differences in bone structure in injured vs. uninjured limbs. No discriminative bone parameter classifications were identified between adolescent athletes with or without SFX.
Since stress fractures are common among adolescent athletes, it is important to identify bone assessment tools that accurately identify risk. We investigated the discriminative ability of two imaging technologies to classify at-risk athletes. Findings suggested that peripheral quantitative computed tomography (pQCT) has the ability to distinguish differences in bone structure in injured vs. uninjured limbs. INTRODUCTION: Given the high stress fracture (SFX) prevalence among adolescent girls, an understanding of the most informative assessment tools to identify SFX risks are required. We investigated the discriminative ability of pQCT vs. dual-energy X-ray absorptiometry (DXA) to classify athletes with or without SFX. METHODS: Twelve adolescent athletes diagnosed with a lower-extremity SFX were compared with 12 matched controls. DXA measured areal bone mineral density (aBMD) and content of the total body, and lumbar spine. Bilateral tibiae were assessed with pQCT. At the metaphysis (3%), total density (ToD), trabecular density (TrD), trabecular area (TrA), and estimated bone strength in compression (BSIc), and at the diaphysis (38% and 66%), total bone area (ToA), cortical density (CoD), cortical area (CoA), estimated bone strength in torsion (SSIp), and peri- and endocortical and muscle area (MuA) were obtained. Cortical bone mass/density around the center of mass and marrow density (estimate of adiposity) were calculated using ImageJ software. General estimated equations adjusting for multiple comparisons (Holm-Bonferroni method) were used to compare means between (1) injured limb of the case athletes vs. uninjured limb of the control athletes and (2) uninjured limb of the case athletes vs. uninjured limbs of the controls and injured vs. uninjured limb of case athletes with a SFX. RESULTS: aBMD and content showed no significant differences between cases and controls. When comparing the injured vs. uninjured leg in the case athletes by pQCT at the 3% tibia, unadjusted TrD, total density, and BSIc were significantly lower (p < 0.05) in the injured vs. uninjured leg. Marrow density at the 66% site was 1% (p < 0.05) lower in the injured vs. uninjured leg. CONCLUSIONS: These preliminary data in athletes with SFX suggest that pQCT has the ability to distinguish differences in bone structure in injured vs. uninjured limbs. No discriminative bone parameter classifications were identified between adolescent athletes with or without SFX.
Entities:
Keywords:
Bone mineral density; Females; Marrow density; Stress fracture; Trabecular density
Authors: Katharina E Schnackenburg; Heather M Macdonald; Reed Ferber; J Preston Wiley; Steven K Boyd Journal: Med Sci Sports Exerc Date: 2011-11 Impact factor: 5.411
Authors: K L Bennell; S A Malcolm; S A Thomas; S J Reid; P D Brukner; P R Ebeling; J D Wark Journal: Am J Sports Med Date: 1996 Nov-Dec Impact factor: 6.202
Authors: K L Bennell; S A Malcolm; P D Brukner; R M Green; J L Hopper; J D Wark; P R Ebeling Journal: Calcif Tissue Int Date: 1998-07 Impact factor: 4.333
Authors: K L Bennell; S A Malcolm; S A Thomas; P R Ebeling; P R McCrory; J D Wark; P D Brukner Journal: Clin J Sport Med Date: 1995-10 Impact factor: 3.638
Authors: Kirsten Ecklund; Sridhar Vajapeyam; Henry A Feldman; Catherine D Buzney; Robert V Mulkern; Paul K Kleinman; Clifford J Rosen; Catherine M Gordon Journal: J Bone Miner Res Date: 2010-02 Impact factor: 6.741
Authors: Mark J Hutson; Emma O'Donnell; Katherine Brooke-Wavell; Craig Sale; Richard C Blagrove Journal: Sports Med Date: 2021-03 Impact factor: 11.136