Evidence map›Paper›PMID 40494912›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Quantifying localized bone loss in clinical computed tomography using void spaces.

Annabel R Bugbird, Bryn E Matheson, Matthias Walle, Nathan J Neeteson, Nina Pavlovic, Callie E Stirling, Danielle E Whittier, Steven K Boyd

Abstract readValidation Study
PubMed Publisher
In one paragraph

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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Intramuscular fat infiltration is associated with higher vertebral void space burden and lower volumetric bone mineral density in older adults.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Annabel R BugbirdMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Bryn E MathesonMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Matthias WalleMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Nathan J NeetesonMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Nina PavlovicMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Callie E StirlingMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Danielle E WhittierMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Steven K BoydMcCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. skboyd@ucalgary.ca.ORCID http://orcid.org/0000-0002-2930-5997

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Localized bone loss, known as void spaces, is not captured using standard measures in clinical computed tomography (CT). This study validated the use of CT to systemically assess void spaces throughout the skeleton. We found that void spaces were localized to skeleton regions (e.g., L3 vs L4), providing new insights into bone fragility.

introductionLocalized trabecular bone microarchitectural loss, referred to as void spaces, can be measured using HR-pQCT and is related to bone fragility. Due to gantry size constraints, HR-pQCT is limited to peripheral sites; therefore, it is unknown whether these features occur at axial skeletal sites. This study aimed to validate the use of quantitative computed tomography (QCT) to assess void spaces at the hip and spine and combine those measures with HR-pQCT to determine its systemic skeletal prevalence.

methodsThe original methodology developed to identify void spaces on HR-pQCT was adapted for QCT to accommodate its lower resolution and was validated in 101 participants scanned using both modalities. Validation was performed by comparing void space volume (VS), void space volume ratio (VS/TV), and the Euclidean distance between void space centroids across both modalities. Subsequently, void spaces were measured on a separate cohort of 209 participants who were scanned with HR-pQCT (radius and tibia) and QCT (lumbar spine and hip). Pearson's correlation assessed VS and VS/TV relationships across skeletal sites.

resultsValidation at the knee was confirmed by a strong Pearson correlation between HR-pQCT and QCT for VS (r = 0.88,

conclusionThis study validated the use of QCT to identify void spaces by comparison with HR-pQCT. Across skeletal sites, void spaces tended to be localized to skeletal regions (e.g., L3 vs L4) rather than systemic throughout the skeleton (e.g., L1 vs radius). Tracking void spaces offers insights into bone fragility and may help direct orthopedic treatment options such as hip arthroplasty or bone hydrogels in the future.

Indexed as

OsteoporosisAgedAged, 80 and overBone DensityCancellous BoneFemaleHip JointHumansLumbar VertebraeMaleMiddle AgedTomography, X-Ray ComputedBone lossHigh-resolution peripheral quantitative computed tomographyOsteoporosisQuantitative computed tomographyVoid space

Identifiers

PMID40494912

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.