Tsuda K
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1993 Nov;67(11):1033-44.
Bone mineral density (BMD) of the metacarpal and phalangeal bones of the hand was evaluated using dual X-ray absorptiometry (DXA) in 104 healthy subjects, 35 patients with rheumatoid arthritis (RA) and 6 young male volunteers with a short arm cast. BMD was positively correlated with the bone volume of metacarpal and phalangeal bones in skeletal specimens. In healthy subjects, the mean values for BMD of metacarpals of the index and middle fingers were significantly higher than those of the ring and little fingers (p < 0.001). The BMD of the middle proximal phalanx was the highest among the proximal phalanges. The BMD of the middle phalanges was the same pattern as in the proximal phalanges. There was no significant difference in the BMD of the distal phalanges between the fingers. In 62 healthy women aged from 22 to 82 years, BMD was at its peak in the metacarpal and proximal phalangeal bones in their thirties, and in the distal phalanges in their forties. Thereafter, BMD decreased linearly with age. In contrast, age-related changes in BMD were not shown in 42 healthy men aged from 22 to 76 years. BMD of the metacarpal and phalangeal bones in RA markedly decreased with disease stage. Four-week immobilization of the hand by a short arm cast affected BMD of the metacarpal bones in 6 healthy volunteers. The mean change in BMD was -4.1% after 4 weeks of immobilization, followed by a return to the initial value in 12 weeks after removal of the plaster. We concluded that the bone mineral measurement of metacarpal and phalangeal bones could be useful for evaluation of age-related bone loss and the deterioration of bone in metabolic disorders.
采用双能X线吸收法(DXA)对104名健康受试者、35名类风湿关节炎(RA)患者以及6名佩戴短臂石膏的年轻男性志愿者的手部掌骨和指骨骨密度(BMD)进行了评估。BMD与骨骼标本中掌骨和指骨的骨体积呈正相关。在健康受试者中,示指和中指掌骨的BMD平均值显著高于环指和小指(p<0.001)。近端指骨中,中节近端指骨的BMD最高。中节指骨的BMD模式与近端指骨相同。各手指远端指骨的BMD无显著差异。在62名年龄在22至82岁的健康女性中,掌骨和近端指骨的BMD在三十多岁时达到峰值,远端指骨在四十多岁时达到峰值。此后,BMD随年龄呈线性下降。相比之下,在42名年龄在22至76岁的健康男性中未显示出与年龄相关的BMD变化。RA患者掌骨和指骨的BMD随疾病分期显著降低。6名健康志愿者佩戴短臂石膏对手部进行四周固定影响了掌骨的BMD。固定4周后BMD的平均变化为-4.1%,去除石膏后12周恢复到初始值。我们得出结论,掌骨和指骨的骨矿物质测量对于评估年龄相关的骨质流失和代谢紊乱中的骨质恶化可能是有用的。