ArticleBMC musculoskeletal disorders2026
Sex and age differences in regional distribution of bone mineral density in the pubic symphysis using Computed Tomography Osteoabsorptiometry (CT-OAM).
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSubchondral bone (SCB) remodels in response to long-term mechanical loading, with mineralisation patterns reflecting chronic mechanical stress. Computed tomography osteoabsorptiometry (CT-OAM) enables non-invasive visualisation of these adaptations. While CT-OAM has been widely applied to several joints, its use in the pubic symphysis is limited. This study aimed to identify sex- and age-related differences in mineralisation patterns and quantify bone mineral density (BMD) distribution across the symphyseal surfaces.
methodsCT scans from 85 individuals (51 males, 34 females; age range 18–97 years) were analysed, generating 170 symphyseal surfaces. Segmented three-dimensional reconstructions were processed into HU-based densitograms. Mineralisation was classified qualitatively into three patterns: diffuse across the surface (Pattern 1), ventral border with/without inferior apex involvement (Pattern 2), and dorsal border with/without inferior apex involvement (Pattern 3). Quantitatively, each surface was subdivided into six anatomical subregions, and mean HU values were compared by sex, side, and age.
resultsAcross all specimens, Pattern 2 predominated (58%), with Pattern 2 most frequent in males (76%) and Pattern 3 in females (55%). High bilateral conformity (81%) was observed. Males exhibited significantly higher mean HU values than females (554 ± 180 HU vs. 374 ± 111 HU, p < 0.01), with greater BMD across all subregions. Region-specific analyses revealed highest mineralisation anteriorly and inferiorly in males, while females displayed increased posterior mineralisation. No significant correlation was found between overall BMD and age; however, females demonstrated a weak negative correlation in the ventral middle region (r = − 0.24, p < 0.05).
conclusionThis study provides the first systematic CT-OAM analysis of pubic symphyseal SCB mineralisation. Findings highlight sex-specific patterns, with males demonstrating greater anterior and inferior mineralisation, and females exhibiting posterior dominance. Males also displayed higher overall BMD, reflecting greater chronic loading. These results deepen understanding of pelvic biomechanics and may inform future research on conditions such as osteitis pubis.
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