ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017
The comparability of HR-pQCT bone measurements is improved by scanning anatomically standardized regions.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Meta-analyses of the quantitative computed tomography data in dialysis patients show differential impacts of renal failure on the trabecular and cortical bones.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Non-invasive quantification of bone (re)modeling dynamics in adults with osteogenesis imperfecta treated with setrusumab using timelapse high-resolution peripheral-quantitative computed tomography.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Trial
- Article
- Associations of muscle strength and functional power with longitudinal change in HR-pQCT bone parameters: the Osteoporotic Fractures in Men (MrOS) Study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Sex- and site-specific reference data for size-invariant properties using multi-stack HRpQCT.JBMR plus · 2026Article
- Sex-Specific Associations of Radiographic Knee Osteoarthritis and Pain with Distal Tibia Bone Microarchitecture: the Study of Muscle, Mobility and Aging (SOMMA).Calcified tissue international · 2026Article
- Risk Factors for Bone Microarchitecture Impairments in Older Men With Type 2 Diabetes-The MrOS Study.The Journal of clinical endocrinology and metabolism · 2025Article
- Patella fractures are associated with bone fragility - a retrospective study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- The Bone, Exercise, Alendronate, and Caloric Restriction (BEACON) trial design and methods.Contemporary clinical trials · 2024Article
- Diabetes Risk Factors and Bone Microarchitecture as Assessed by High-Resolution Peripheral Quantitative Computed Tomography in Adults With Long-standing Type 1 Diabetes.Diabetes care · 2024Article
- Am I big boned? Bone length scaled reference data for HRpQCT measures of the radial and tibial diaphysis in White adults.Bone reports · 2024Article
- Recommendations for High-resolution Peripheral Quantitative Computed Tomography Assessment of Bone Density, Microarchitecture, and Strength in Pediatric Populations.Current osteoporosis reports · 2023Review
- Cortical thickness mapping at segmented regions in the distal radius using HR-pQCT.Journal of bone and mineral metabolism · 2022Article
- Impaired Bone Microarchitecture at Distal Radial and Tibial Reference Locations Is Not Related to Injury Site in Athletes With Bone Stress Injury.The American journal of sports medicine · 2022Article
- Bone Microarchitecture and Strength in Long-Standing Type 1 Diabetes.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Reference data and calculators for second-generation HR-pQCT measures of the radius and tibia at anatomically standardized regions in White adults.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Reference values and clinical predictors of bone strength for HR-pQCT-based distal radius and tibia strength assessments in women and men.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Guidelines for the assessment of bone density and microarchitecture in vivo using high-resolution peripheral quantitative computed tomography.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Biological basis of bone strength: anatomy, physiology and measurement.Journal of musculoskeletal & neuronal interactions · 2020Review
- Associations between physical activity and bone structure in older adults: does the use of self-reported versus objective assessments of physical activity influence the relationship?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
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Abstract
We investigated the sensitivity of distal bone density, structure, and strength measurements by high-resolution peripheral quantitative computed tomography (HR-pQCT) to variability in limb length. Our results demonstrate that HR-pQCT should be performed at a standard %-of-total-limb-length to avoid substantial measurement bias in population study comparisons and the evaluation of individual skeletal status in a clinical context.
introductionHigh-resolution peripheral quantitative computed tomography (HR-pQCT) measures of bone do not account for anatomic variability in bone length: a 1-cm volume is acquired at a fixed offset from an anatomic landmark. Our goal was to evaluate HR-pQCT measurement variability introduced by imaging fixed vs. proportional volumes and to propose a standard protocol for relative anatomic positioning.
methodsDouble-length (2-cm) scans were acquired in 30 adults. We compared measurements from 1-cm sub-volumes located at the default fixed offset, and the average %-of-length offset. The average position corresponded to 4.0% ± 1.1 mm for radius, and 7.2% ± 2.2 mm for tibia. We calculated the RMS difference in bone parameters and T-scores to determine the measurement variability related to differences in limb length. We used anthropometric ratios to estimate the mean limb length for published HR-pQCT reference data, and then calculated mean %-of-length offsets.
resultsVariability between fixed vs. relative scan positions was highest in the radius, and for cortical bone in general (RMS difference Ct.Th = 19.5%), while individuals had T-score differentials as high as +3.0 SD (radius Ct.BMD). We estimated that average scan position for published HR-pQCT reference data corresponded to 4.0% at the radius, and 7.3% at tibia.
conclusionVariability in limb length introduces significant bias to HR-pQCT measures, confounding cross-sectional analyses and limiting the clinical application for individual assessment of skeletal status. We propose to standardize scan positioning using 4.0 and 7.3% of total bone length for the distal radius and tibia, respectively.
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