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KMID : 1100120200270040261
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대한골대사학회지
2020 Volume.27 No. 4 p.261 ~ p.266
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The 2nd Metacarpal Cortical Index as a Simple Screening Tool for Osteopenia
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Patel Bhavika
Aqil Adeel
Riaz Osman
Jeffers Russ
Dickson David
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Abstract
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Background: Osteopenia is a known risk factor for sustaining skeletal fractures. Prevention of fragility fractures has obvious clinical and economic advantages, however screening all patients using a dual energy X-ray absorptiometry (DXA) is controversial not only because of the cost implications but also because it would potentially involve exposing a percentage of normal patients to unnecessary radiation. We wished to assess whether a simple hand X-ray measuring the 2nd metacarpal cortical index (2MCI) could be used as a simple screening tool for identifying patients with osteopenia.
Methods: We retrospectively collected the radiographic data of 206 patients who had a simple radiograph of the hand and a DXA scan within one year of each other from our picture archiving and communication system database. The 2MCI was calculated for all patients. As data was parametric, a Pearson’s correlation was performed to assess association between Tscores and 2MCI. Further analysis involved the construction of receiver operating characteristic (ROC) curves to identify a 2MCI index, which would give the most appropriate sensitivity and specificity values for identifying the presence of osteopenia.
Results: A statistically significant and moderate correlation between DXA T-scores and 2MCI values was found (r=0.54, n=206, P<0.001). Further ROC curve analysis of normal and osteopenic subjects identified that a 2MCI of 41.5 had a sensitivity of 100% and specificity of 53% for detecting osteopenia.
Conclusions: Our results support the use of the 2MCI as a simple screening tool for identifying patients with osteopenia.
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KEYWORD
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Bone diseases, metabolic, Metacarpus, Osteoporosis, Radiography
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