Sakai Tomoko, Hirao Masanobu, Takashina Yusuke, Kitagawa Ryo, Oishi Tsutomu
Department of Rehabilitation Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku Tokyo 113-8519, Japan.
Department of Pediatrics, Akitsu Ryoikuen, 3-31-1, Aobacho Higashimurayama, Tokyo 189-0002, Japan.
Bone Rep. 2024 Jun 21;22:101781. doi: 10.1016/j.bonr.2024.101781. eCollection 2024 Sep.
Radiofrequency echographic multi-spectrometry (REMS) is an ultrasound technology currently used for the densitometric evaluation of osteoporosis and has been validated against dual-energy X-ray absorptiometry. However, the use of REMS for bone densitometry in patients with severe motor and intellectual disabilities (SMID) remains to be reported. This study aimed to investigate whether REMS technology can be used for densitometric evaluation of osteoporosis in patients with SMID with hip dislocation and severe scoliosis.
Sixty-five patients with SMID, who resided in a long-term care facility and received comprehensive medical and rehabilitation care, underwent REMS scans of the femoral neck and/or lumbar spine. Data regarding anthropometric parameters (height and weight), bone mineral density (BMD), clinical diagnostic classification, physical ability, presence of scoliosis and hip dislocation, and frontal radiographs of both hip joints were obtained.
We included 29 men and 34 women (mean age: 52.6 years). All patients underwent successful scanning at either the femoral neck (82.5 %) or lumbar spine (95.2 %). BMD measurements obtained using REMS revealed low values, with a mean BMD, T-score, and -score of 0.67 g/cm, -2.39 standard deviation (SD), and - 1.38 SD, respectively, at the femoral neck and 0.66 g/cm, -2.70 SD, and - 1.87 SD, respectively, at the lumbar spine. The average Cobb angle of the lumbar spine was 34.0°; furthermore, dislocation rates did not significantly differ between those with and without successful BMD measurements ( = 0.073). Lumbar BMD T-scores were significantly correlated with femoral neck BMD T-scores ( < 0.001, = 0.530).
All patients with SMID were able to undergo measurements of either spinal or femoral neck BMD; furthermore, 77.7 % of the patients underwent measurements at both the lumbar spine and femur. Our data suggest that REMS is useful for measuring BMD in patients with SMID who are residing in institutions.
射频超声多光谱测定法（REMS）是一种目前用于骨质疏松症密度评估的超声技术，并且已通过双能X线吸收法验证。然而，关于REMS在重度运动和智力残疾（SMID）患者骨密度测定中的应用尚未见报道。本研究旨在调查REMS技术是否可用于患有髋关节脱位和严重脊柱侧弯的SMID患者的骨质疏松症密度评估。
65例居住在长期护理机构并接受全面医疗和康复护理的SMID患者接受了股骨颈和/或腰椎的REMS扫描。获取了有关人体测量参数（身高和体重）、骨矿物质密度（BMD）、临床诊断分类、身体能力、脊柱侧弯和髋关节脱位情况以及双侧髋关节正位X线片的数据。
我们纳入了29名男性和34名女性（平均年龄：52.6岁）。所有患者在股骨颈（82.5%）或腰椎（95.2%）均成功进行了扫描。使用REMS获得的BMD测量值显示较低，股骨颈处的平均BMD、T值和Z值分别为0.67g/cm、-2.39标准差（SD）和-1.38 SD，腰椎处分别为0.66g/cm、-2.70 SD和-1.87 SD。腰椎的平均Cobb角为34.0°；此外，成功进行BMD测量的患者与未成功测量的患者之间的脱位率无显著差异（P = 0.073）。腰椎BMD T值与股骨颈BMD T值显著相关（P < 0.001，r = 0.530）。
所有SMID患者均能够进行脊柱或股骨颈BMD测量；此外，77.7%的患者在腰椎和股骨均进行了测量。我们的数据表明，REMS对于测量居住在机构中的SMID患者的BMD是有用的。
