Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
BMC Musculoskelet Disord. 2013 Apr 15;14:136. doi: 10.1186/1471-2474-14-136.
Osteoporosis (OP) and osteoarthritis (OA) are two common musculoskeletal disorders that affect the quality of life in aged people. An inverse relationship between OP and OA was proposed four decades ago. However, the difference in microstructure of the trabecular bone of these two disorders by high-resolution MRI (HR-MRI) has not been compared. The primary objective of the study is to explain the actual relationship between OA and OP based on differences between bone microstructure of these two diseases. The secondary objectives are to find out the significance of Euler number and its relationship with other structural parameters, and important role of HR-MRI to reveal the microstructure of trabecular bone directly.
Totally, 30 women with OP and 30 women with OA (n = 60) were included in this study. Primary OA of hip, knee, as well as spinal arthrosis were diagnosed according to plain X-ray film findings. Osteoporosis was defined based on the latest criteria of World Health Organization (WHO). Structural and textural parameters derived from HR-MRI images of proximal tibia were calculated and compared with special software.
There were significant differences in apparent bone volume fraction, trabecular thickness, mean roundness, Euler number, entropy and inverse different moment between OP and OA patients. In OP group, apparent trabecular separation (Tb.Sp), inertia, absolute value and contrast were positively correlated with Euler number, whereas apparent trabecular number (Tb.N), mean trabecular area, inverse difference and inverse different moment were negatively correlated. Apparent trabecular bone volume fraction (BV/TV), mean trabecular area, mean trabecular perimeter and mean skeleton length negatively correlated with Euler number in OA group. Inverse different moment was the texture parameter, which influenced bone mineral density (BMD) of femoral neck, meanwhile contrast influenced BMD of both great trochanter and Ward's triangle in OP group. While in OA group, Euler number was the exclusive parameter, which affected BMD of femoral neck and Ward's triangle.
We found significant differences in microstructure parameters derived from HR-MRI images between postmenopausal women with OP and OA. It convincingly supports the hypothesis that there might be an inverse relationship between OP and OA.
骨质疏松症(OP)和骨关节炎(OA)是两种常见的影响老年人生活质量的肌肉骨骼疾病。四十年来,人们提出了 OP 和 OA 之间存在反比关系的假说。然而,高分辨率 MRI(HR-MRI)对这两种疾病的小梁骨微观结构差异尚未进行比较。本研究的主要目的是基于这两种疾病的骨微观结构差异来解释 OA 和 OP 之间的实际关系。次要目标是找出欧几里得数的意义及其与其他结构参数的关系,以及 HR-MRI 揭示小梁骨微观结构的重要作用。
共纳入 30 例 OP 女性和 30 例 OA 女性(n=60)。根据平片检查结果诊断原发性髋、膝和脊柱关节炎。骨质疏松症根据世界卫生组织(WHO)的最新标准定义。使用特殊软件计算并比较了胫骨近端 HR-MRI 图像的结构和纹理参数。
OP 和 OA 患者的表观骨体积分数、小梁厚度、平均圆形度、欧几里得数、熵和逆差矩均有显著差异。在 OP 组中,表观小梁分离度(Tb.Sp)、惯性、绝对值和对比度与欧几里得数呈正相关,而表观小梁数(Tb.N)、平均小梁面积、逆差和逆差矩与欧几里得数呈负相关。OA 组中,表观小梁骨体积分数(BV/TV)、平均小梁面积、平均小梁周长和平均骨骼长度与欧几里得数呈负相关。逆差矩是影响股骨颈骨密度(BMD)的纹理参数,而对比度则影响 OP 组大转子和 Ward 三角区的 BMD。而在 OA 组中,欧几里得数是唯一影响股骨颈和 Ward 三角区 BMD 的参数。
我们发现绝经后 OP 和 OA 女性 HR-MRI 图像微观结构参数存在显著差异。这有力地支持了 OP 和 OA 之间可能存在反比关系的假说。