Sung Ki Hyuk, Choi Young, Cho Gyeong Hee, Chung Chin Youb, Park Moon Seok, Lee Kyoung Min
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.
Department of Orthopaedic Surgery, Kosin University Gaspel Hospital, Busan, South Korea.
Skeletal Radiol. 2018 Aug;47(8):1111-1117. doi: 10.1007/s00256-018-2876-x. Epub 2018 Feb 5.
This study evaluated the correlation between central and peripheral bone mineral density (BMD) of the ankle joint, using dual-energy X-ray absorptiometry (DXA). We also investigated whether peripheral ankle BMD could be used to identify individuals who were diagnosed with osteoporosis, using central DXA.
We recruited 134 volunteers aged 20-90 years who agreed to participate in this study. Central BMD of the lumbar spine and left femur, and peripheral BMD of the medial malleolus, distal tibia, lateral malleolus, and talus were measured with DXA.
Among the peripheral sites of the ankle, the highest and lowest BMD were observed in the talus and lateral malleolus, respectively. All peripheral DXA measurements of the ankle joint were significantly correlated with central DXA measurements. There was a good correlation (r: 0.656-0.725) between peripheral and central BMD for the older age group (> 50 years), but fair-to-good correlation (r: 0.263-0.654) for the younger age group (< 50 years). The cut-off values for peripheral BMD of the ankle joint between osteoporosis and non-osteoporosis were 0.548 g/cm (sensitivity, 89.0%; specificity, 69.0%) for the medial malleolus, 0.626 g/cm (sensitivity, 83.3%; specificity, 82.8%) for the distal tibia, 0.47 g/cm (sensitivity, 100.0%; specificity, 65.5%) for the lateral malleolus, and 0.973 g/cm (sensitivity, 72.2%; specificity, 83.6%) for the talus (p < 0.001).
This study showed good correlation between peripheral BMD around ankle joint and central BMD for older age group. Further study is required to use the ankle DXA as a valid clinical tool for the diagnosis of osteoporosis and fracture risk assessment.
本研究采用双能X线吸收法（DXA）评估踝关节中央和外周骨密度（BMD）之间的相关性。我们还研究了能否使用外周踝关节骨密度通过中央DXA来识别被诊断为骨质疏松症的个体。
我们招募了134名年龄在20至90岁之间且同意参与本研究的志愿者。使用DXA测量腰椎和左股骨的中央骨密度以及内踝、胫骨远端、外踝和距骨的外周骨密度。
在踝关节的外周部位中，距骨的骨密度最高，外踝的骨密度最低。踝关节的所有外周DXA测量值与中央DXA测量值均显著相关。老年组（>50岁）外周与中央骨密度之间存在良好的相关性（r：0.656 - 0.725），而年轻组（<50岁）的相关性为中等至良好（r：0.263 - 0.654）。踝关节外周骨密度在骨质疏松症与非骨质疏松症之间的截断值分别为：内踝0.548 g/cm（敏感性89.0%；特异性69.0%），胫骨远端0.626 g/cm（敏感性83.3%；特异性82.8%），外踝0.47 g/cm（敏感性100.0%；特异性65.5%），距骨0.973 g/cm（敏感性72.2%；特异性83.6%）（p < 0.001）。
本研究表明老年组踝关节周围外周骨密度与中央骨密度之间存在良好的相关性。需要进一步研究以将踝关节DXA用作诊断骨质疏松症和评估骨折风险的有效临床工具。
