Bone最新文献

{"title":"Schip1 promotes osteoclast differentiation via Taok1-mediated activation of the p38 MAPK signaling pathway in mouse models of osteoporosis","authors":"Furui Liu ,&nbsp;Muhang Tian ,&nbsp;Sen Wang ,&nbsp;Lei Guo ,&nbsp;Fangjing Chen","doi":"10.1016/j.bone.2025.117579","DOIUrl":"10.1016/j.bone.2025.117579","url":null,"abstract":"<div><div>Schip1 serves as a pivotal regulatory factor in both the Hippo pathway and the PDGFB signaling pathway, which are significant in the pathogenesis of osteoporosis. However, the role of Schip1 in osteoporosis remains to be elucidated. In this study, we demonstrated for the first time that Schip1 acted as a positive regulator in osteoclastogenesis. We observed a significant upregulation of Schip1 expression during Rankl-induced osteoclast differentiation, and the suppression of Schip1 expression notably reduced Rankl-induced osteoclast formation. Functionally, Schip1 interacted with Taok1 to activate the p38 MAPK signaling pathway, which promoted osteoclast differentiation. Genetic ablation of Schip1 in mice resulted in pronounced osteosclerosis compared to wild-type controls. Furthermore, mice with deletion of Schip1 exhibited significantly mitigated osteoporosis following ovariectomy. Collectively, our findings establish Schip1 as a regulator of osteoclast differentiation and suggest its potential as a therapeutic target for osteoporosis.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117579"},"PeriodicalIF":3.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical shape modelling of the first carpometacarpal joint: A cross-sectional analysis of an osteoarthritis initiative cohort","authors":"J. Shepherd ,&nbsp;F.R. Saunders ,&nbsp;Y. Narang ,&nbsp;K. Hamlin ,&nbsp;D.F.M. Lawrie ,&nbsp;B. Winter ,&nbsp;A.H.K. Riemen","doi":"10.1016/j.bone.2025.117577","DOIUrl":"10.1016/j.bone.2025.117577","url":null,"abstract":"<div><h3>Introduction</h3><div>Statistical shape modelling (SSM) has been used extensively to investigate the relationship between joint shape and hip, knee and spine osteoarthritis (OA), but first carpometacarpal joint (CMCJ) shape and thumb base OA is less understood. We established a statistical shape model of the first CMCJ to investigate the ability of SSM to evaluate CMCJ morphology and determine its ability to investigate association with thumb base OA.</div></div><div><h3>Methods</h3><div>100 participants' bilateral hand and wrist radiographs were selected at random from the OAI database. A model was developed using SSM software to characterise first CMCJ shape and applied to radiographs. Radiographic OA severity was graded using Kellgren-Lawrence. Independent modes of variation in shape within the cohort were identified. Relationship with clinical symptoms and radiological severity was assessed using multivariate regression models adjusted for age, sex, height and weight.</div></div><div><h3>Results</h3><div>Ten and nine modes of variation were identified in right and left models respectively. Concurrent ipsilateral hand pain and stiffness was associated with right-mode-1 (RM1) (multivariate model, co-efficient 0.104, 95 % CI 0.011–0.197, <em>p</em> = 0.028), which anatomically represents greater prominence of ulnar aspect of trapezium joint surface. Stratified radiological OA severity showed CMCJ severity was associated with RM1,6,10 and LM 1,6,7 and STJ severity was associated with RM1 and LM1,6,7.</div></div><div><h3>Conclusions</h3><div>We demonstrate the application of SSM in a novel context, showing its ability to evaluate variation in CMCJ morphology from radiographs. This study identifies and justifies the requirement for novel automation techniques in SSM to facilitate longitudinal studies required to investigate clinical applications.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117577"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The number of vertebral fractures in indolent systemic mastocytosis is influenced by presence of the KIT-mutation","authors":"Christof Wilke ,&nbsp;Martina Blaschke ,&nbsp;Annette Lamersdorf ,&nbsp;Christina Heppner ,&nbsp;Michael Metz ,&nbsp;Hans-Peter Horny ,&nbsp;Mathias Werner ,&nbsp;Undine Lippert ,&nbsp;Heide Siggelkow","doi":"10.1016/j.bone.2025.117578","DOIUrl":"10.1016/j.bone.2025.117578","url":null,"abstract":"<div><div>Systemic mastocytosis (SM) is a rare disease characterized by aggregation of mast cells in the skin or extracutaneous organs. Disease subtypes range from cutaneous to systemic mastocytosis with highly malignant forms, indolent systemic mastocytosis (ISM) being the most frequent subtype. In ISM, mast cells infiltrate bone marrow, with some patients developing osteoporosis and fractures. However, fractures do not occur in all ISM patients.</div><div>In this retrospective one-center study, we analyzed data from patients evaluated for osteoporosis diagnosed with ISM according to WHO criteria between 2006 and 2019. ISM patients (n = 42) comprised 76.2 % women (n = 32), had a mean age of 52.2 ± 12 years, and presented with skin lesions in 80.5 % (n = 33). Osteoporosis was diagnosed in 42 % (n = 15) according to the WHO definition (T-score ≤ −2.5). Fractures were either peripheral in 19 % (n = 8), or to the spine in 43 % (n = 18); both fracture types presented in 14 % (n = 6). All fracture types correlated to femoral BMD T-scores. The presence of the somatic gain-of-function mutation in the KIT receptor tyrosine kinase (KIT-mutation) in bone biopsy was associated with a significantly greater number of fractures (p = 0.024) and correlated to the number of vertebral fractures in individual patients (p = 0.03). Neither tryptase levels, postmenopausal status, nor bone turnover markers were indicators of an increase in vertebral or peripheral fractures in ISM patients. Smoking was associated with more fractures, however the effect disappeared dependent on KIT-mutation. Those with skin lesions had better femoral BMD T-scores (right femur: −1.05 ± 0.99 vs −2.26 ± 0.59, p = 0.008; right femoral neck: −1.21 ± 0.99 vs −2.22 ± 0.55, p = 0.0023).</div><div>In conclusion, we demonstrate the influence of the KIT-mutation on the severity of fractures in osteoporosis patients with the final diagnosis of ISM. Our results suggest that, in the presence of the KIT-mutation in ISM patients without skin lesions, the timely onset of anti-osteoporotic treatment might be of value.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117578"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics based on BPX images to detect abnormal bone mineral density","authors":"Yuqi Zhu ,&nbsp;Kun Zhou ,&nbsp;Xiao Luo ,&nbsp;Shan Yang ,&nbsp;Enhui Xin ,&nbsp;Yanwei Zeng ,&nbsp;Junyan Fu ,&nbsp;Zhuoying Ruan ,&nbsp;Rong Wang ,&nbsp;Liqin Yang ,&nbsp;Daoying Geng","doi":"10.1016/j.bone.2025.117570","DOIUrl":"10.1016/j.bone.2025.117570","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal bone mineral density (BMD) is a major contributor to bone fragility and fractures. While dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) are the primary diagnostic modalities, both methods are associated with additional radiation exposure and costs. This study investigates the feasibility of using radiomics to establish an automated tool for identifying patients at high risk for BMD abnormality based on biplanar X-ray radiography (BPX) images.</div></div><div><h3>Methods</h3><div>A total of 906 BPX scans from 453 subjects, including 275 females, were included in this prospective study, with QCT results as the ground truth (GT). Radiomic features were extracted from the anteroposterior and lateral views of the L1-L5 vertebrae using Pyradiomics. The most relevant features were selected using the least absolute shrinkage and selection operator (LASSO) filter. Then, radiomics-only and clinical-radiomics models were established to diagnose BMD abnormality. The performances of the models were calculated and evaluated.</div></div><div><h3>Results</h3><div>The radiomics-only model achieved an accuracy (ACC) of 0.88 for both sexes and 0.91 for women. The clinical-radiomics models achieved an ACC of 0.87 for both sexes and 0.89 for women.</div></div><div><h3>Conclusion</h3><div>The radiomics-only model based on BPX images effectively distinguishes BMD abnormality and demonstrates potential as a decision-support tool in real-world physical examination populations.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117570"},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned emergency room visits within 30 and 90 days after osteoporotic hip fracture surgery: A comprehensive risk factor analysis","authors":"Chul-Ho Kim,&nbsp;Joon Hyoung Hong,&nbsp;Chan Woo La,&nbsp;Ji Wan Kim","doi":"10.1016/j.bone.2025.117576","DOIUrl":"10.1016/j.bone.2025.117576","url":null,"abstract":"<div><div>Hip fractures in older adults are associated with high comorbidity and mortality rates. Despite efforts to reduce hospital stay, early emergency room (ER) visits and readmissions remain common and can negatively impact outcomes. In this study, we aimed to evaluate the incidence, causes, and risk factors of unplanned ER visits within 30 and 90 days following hip fracture surgery. A retrospective review was conducted of 4551 patients who underwent hip fracture surgery at a single institution between 2005 and 2024. Demographics, perioperative variables, and clinical risk factors were analyzed using univariate and multivariate logistic regression. ER visits within 30 and 90 days post-discharge were categorized as surgical or non-surgical and compared with control groups without ER visits. The rates of unplanned ER visits were 6.8 % within 30 days and 12.2 % within 90 days after discharge. Multivariate analysis identified low body mass index (BMI) and higher Charlson Comorbidity Index scores as significant risk factors for ER visits at both time points. Non-surgical complications—most commonly gastrointestinal and pulmonary—were the leading causes of ER visits. Among surgical complications, hip arthroplasty dislocation was the most frequent cause at both 30 and 90 days. Unplanned ER visits following hip fracture surgery are primarily driven by non-surgical complications. Low BMI and poor preoperative comorbidity status are key risk factors. Targeted preventive strategies, including those addressing modifiable surgical risks, such as prosthetic dislocation, may help reduce ER utilization and improve postoperative outcomes.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117576"},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-world analysis of the clinical and healthcare burden associated with osteogenesis imperfecta","authors":"Pranav Abraham,&nbsp;Gandarvaka Miles,&nbsp;Natalia Petruski-Ivleva,&nbsp;Kalyani Hawaldar,&nbsp;Cemre Robinson,&nbsp;Kenneth I. Berger","doi":"10.1016/j.bone.2025.117572","DOIUrl":"10.1016/j.bone.2025.117572","url":null,"abstract":"<div><h3>Introduction</h3><div>The healthcare resource utilization (HCRU) and cost burden of osteogenesis imperfecta (OI) in US clinical practice is currently unclear.</div></div><div><h3>Methods</h3><div>This real-world, retrospective study assessed patients with ≥1 inpatient claim or ≥ 2 outpatient claims with <em>ICD-10</em> codes for OI using Optum's deidentified Clinformatics® Data Mart Database (Oct 1, 2015–Nov 30, 2023). Patients were required to have ≥24 months' continuous healthcare plan enrollment; index date was first claim with OI diagnosis code. Patients with OI were matched 1:5 with non-OI patients on age, sex, index date, and follow-up duration. Comorbidities, fractures, HCRU, and costs per person-year (PPY) were stratified by age (≤19 years, 20–54 years, ≥55 years). Continuous and categorical variables were compared using <em>t-</em>tests and chi-square tests, respectively. Generalized linear and logistic regression models were constructed for HCRU and costs.</div></div><div><h3>Results</h3><div>Overall, 1367 patients with OI (≤19 years, <em>n</em> = 324; 20–54 years, <em>n</em> = 521; ≥55 years, <em>n</em> = 522) were matched with 6835 non-OI controls. HCRU was more frequent in patients with OI versus controls; PPY inpatient admissions were 0.17 versus 0.05 (≤19 years), 0.20 versus 0.11 (20–54 years), and 0.32 versus 0.15 (≥55 years) (<em>p</em> &lt; 0.01). OI patients had higher total healthcare costs than non-OI controls (≤19 years, $26,892 vs $10,134; 20–54 years, $27,673 vs $16,101; ≥55 years, $42,335 vs $25,143 PPY) (<em>p</em> &lt; 0.01), driven by increased outpatient visits (pediatrics) and inpatient admissions (adults).</div></div><div><h3>Conclusion</h3><div>Substantial clinical and economic burden was observed in patients with OI in US clinical practice. These findings may inform evaluation of disease-modifying therapies.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"200 ","pages":"Article 117572"},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractal analysis of mandibular bone structure in children with amelogenesis imperfecta","authors":"Tulin Tasdemir ,&nbsp;Melek Tassoker","doi":"10.1016/j.bone.2025.117571","DOIUrl":"10.1016/j.bone.2025.117571","url":null,"abstract":"<div><h3>Objective</h3><div>Amelogenesis imperfecta (AI) is a hereditary disorder that affects the structure and composition of primary and permanent teeth. Genetic mutations of AI, especially in the FAM83H gene, can reduce osteogenic marker expression and impair bone mineralization. This study aims to assess radiomorphometric indices and fractal dimension (FD) in dental panoramic radiographs of children with AI and to identify differences compared to control subjects.</div></div><div><h3>Study design</h3><div>The study involved 12 patients with AI and 12 age- and gender-matched healthy individuals. Mandibular Cortex Index [1]. scores were assessed, and fractal analysis using ImageJ was conducted on selected regions from the condyle, gonial, and interdental areas to calculate FD values. Statistical analyses were performed using the Student <em>t</em>-test for normally distributed variables, the Mann-Whitney <em>U</em> test for non-normally distributed variables, and the chi-square test for categorical variables, with <em>p</em> &lt; 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Analysis of FD values revealed significant differences on the right side, where controls exhibited higher FD values than AI patients (<em>p</em> = 0.011 for condyle and gonial regions, <em>p</em> = 0.041 for dentate region). No significant differences were observed on the left side. Regarding MCI, the most common score was C1 in both groups, with no significant difference in distribution (<em>p</em> = 0.667).</div></div><div><h3>Conclusion(s)</h3><div>It was found that the FD of the mandibular bone in AI patients was lower than in healthy individuals and this was more pronounced on the right side. The results suggest that AI may affect not only tooth enamel but also the mandibular bone structure.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117571"},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cathepsin D and G expression correlates with human fracture healing phases and specific neutrophil N1 and N2 phenotypes","authors":"Fangzhou Lu ,&nbsp;Rald V.M. Groven ,&nbsp;Dennis M. Meesters ,&nbsp;Albert Bitorina ,&nbsp;Martijn Poeze ,&nbsp;Shan Tang ,&nbsp;Martijn van Griensven ,&nbsp;Taco J. Blokhuis ,&nbsp;Ronit Shiri-Sverdlov","doi":"10.1016/j.bone.2025.117574","DOIUrl":"10.1016/j.bone.2025.117574","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The role and involvement of immune cells in the fracture healing cascade, specifically neutrophils, is not yet fully understood. During tissue regeneration, cathepsin (CTS) D and cathepsin G have been identified as being involved in various cellular processes and associated with neutrophil function. This study aimed to determine the expression of these 2 cathepsins in fracture hematoma. Firstly, these two cathepsins were identified and scrutinized using a bioinformatics approach. Secondly, these two cathepsins were investigated for their expression in the human fracture hematoma (FH) as well as in N1 (pro-inflammatory) and N2 (regenerative) neutrophil phenotypes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;To review the latest research on CTSD and G gene expressions in fracture healing, bioinformatics analysis was firstly performed. Subsequently, to identify CTSD and G genes, the expression of them was assessed in human FH samples throughout different phases of the fracture healing cascade, and potential correlations with patient characteristics were explored. To confirm that gene expression translated to protein production, their corresponding protein levels in FH were evaluated &lt;em&gt;via&lt;/em&gt; immunofluorescence. Finally, human neutrophils were harvested and polarized into N0, N1, or N2 phenotypes, after which their expression of CTSD and CTSG was analyzed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Bioinformatics analysis revealed distinct expression patterns of CTSD and CTSG in the fracture healing cascade in one earlier rodent study. In human, 58 FHs (0–19 days post-trauma) were harvested. The expression of CTSD significantly increased over fracture healing time, while the expression of CTSG remained constant throughout the early phases of fracture healing. Both proteins were found to be expressed throughout the FH. In neutrophils from five human donors, the expression of CTSD was higher in N2 neutrophils compared to N1, while CTSG was expressed more in N1 compared to N2 neutrophils.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study was the first to investigate the association of CTSD and CTSG in the fracture healing cascade. It was shown that the expression of CTSD enzyme was associated with early fracture healing phases, as well as with specific neutrophil phenotypes (N1 or N2). Furthermore, these expression dynamics of CTSD and CTSG support the increasing N2/N1 phenotype ratio over time during fracture healing in humans, reflecting a shift from inflammation to regeneration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;The translational potential of this article&lt;/h3&gt;&lt;div&gt;This study determined to investigate the cathepsin D and G expression in human fracture healing after reviewing the latest research progress. Along with characterizing the dynamics of these cathepsins in fracture hematoma, we demonstrate their association with two distinct neutrophil phenotypes, N1 and N2. These findings enhance the understanding of cathepsins and the roles of N1 and","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117574"},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor: “Global, regional, and national burden and trends analysis of malignant neoplasm of bone and articular cartilage from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021”","authors":"Jianqiang Lai","doi":"10.1016/j.bone.2025.117569","DOIUrl":"10.1016/j.bone.2025.117569","url":null,"abstract":"","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117569"},"PeriodicalIF":3.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of lateral lumbar spine DXA to age-related bone loss, aortic calcification, scoliosis and vertebral degeneration: Analysis of over 10,000 patients","authors":"Nina E. Hänninen ,&nbsp;Antti Voss ,&nbsp;Suvi Hartikainen ,&nbsp;Tomi Nissinen ,&nbsp;Pentti Rautio ,&nbsp;Reijo Sund ,&nbsp;Sami P. Väänänen","doi":"10.1016/j.bone.2025.117564","DOIUrl":"10.1016/j.bone.2025.117564","url":null,"abstract":"<div><div>Dual-energy X-ray absorptiometry (DXA) is a valuable tool for measuring bone mineral density (BMD). Conventional skeletal projection images for BMD assessment include the hip and the posterior-anterior (PA) lumbar spine DXA scans. However, the PA view suffers from the pileup of anatomical structures which are not present in the lateral view. This study aimed to evaluate the significance of lateral projection in measuring BMD.</div><div>We acquired a dataset covering over 10,000 patients with the lateral projection included in the routine clinical DXA examination together with PA lumbar spine and femur projections. Age-related BMD decrease was more pronounced in the lateral lumbar spine and femur than in the PA lumbar spine. To elaborate on this difference, we estimated aortic calcification score from lateral spine DXA images and detected degeneration and scoliosis from PA lumbar spine images using neural networks. Multivariate linear regression analysis suggested that aortic calcification increased BMD in PA spine, but in lateral spine and femur, the expected decline in BMD was observed. The spinal degeneration was related to higher BMD in all sites, with the largest effect on PA spine BMD. Scoliosis increased BMD on lateral spine but was associated with decreased BMD in PA spine and at femur.</div><div>Lateral lumbar spine DXA helped to reveal sources for the artificially elevated BMD and provided better insight into age-related decrease in vertebral bone mineral density than the PA scan. Lateral projection should therefore be considered more in clinical practice, as it enhances the reliability of lumbar spine BMD measurement.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"199 ","pages":"Article 117564"},"PeriodicalIF":3.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}