Distal radial cortical bone thickness correlates with bone mineral density and can predict osteoporosis: a cohort study

Background: We evaluated the correlation of the bone mineral density (BMD) of the hip and lumbar spine with the distal radius cortical thickness (DRCT) measured on anteroposterior radiographs to establish a method for predicting osteoporosis. Methods We assessed 147 patients aged ≥50 years with distal radius fractures who underwent wrist radiographs and dual-energy X-ray absorptiometry. The DRCT was measured and calculated at two levels of the distal radius of the injured wrist on the radiographs. Results In the Pearson correlation and simple linear regression analyses, the DRCT was positively correlated with hip BMD (r = 0.393, P < 0.01) and lumbar spine BMD (r = 0.529, P < 0.01). Each 1-mm increase in DRCT was associated with a 0.051-g/cm 2 increase in hip BMD (R 2 = 0.154, P < 0.01) and a 0.080-g/cm 2 increase in lumbar spine BMD (R 2 = 0.280, P < 0.01). A DRCT of 5.1 mm was selected as the cutoff point for predicting osteoporosis, with the highest Youden index of 0.560, 83.3% sensitivity, 72.7% specificity, and a 66.7% negative predictive value. Conclusion Cortical thickness measurements obtained from anteroposterior wrist radiographs were positively correlated with hip and lumbar spine BMD measurements. This technique is suggested as a rapid, inexpensive, and sensitive method for predicting osteoporosis.