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3 Tesla MRI detects deterioration in proximal femur microarchitecture and strength in long‐term glucocorticoid users compared with controls
Author(s) -
Chang Gregory,
Rajapakse Chamith S.,
Regatte Ravinder R.,
Babb James,
Saxena Amit,
Belmont H. Michael,
Honig Stephen
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24927
Subject(s) - medicine , femoral neck , osteoporosis , glucocorticoid , bone mineral , nuclear medicine , magnetic resonance imaging , femur , radiology , surgery
Background Glucocorticoid‐induced osteoporosis (GIO) is the most common secondary form of osteoporosis, and glucocorticoid users are at increased risk for fracture compared with nonusers. There is no established relationship between bone mineral density (BMD) and fracture risk in GIO. We used 3 Tesla (T) MRI to investigate how proximal femur microarchitecture is altered in subjects with GIO. Methods This study had institutional review board approval. We recruited 6 subjects with long‐term (> 1 year) glucocorticoid use (median age = 52.5 (39.2–58.7) years) and 6 controls (median age = 65.5 [62–75.5] years). For the nondominant hip, all subjects underwent dual‐energy x‐ray absorptiometry (DXA) to assess BMD and 3T magnetic resonance imaging (MRI, 3D FLASH) to assess metrics of bone microarchitecture and strength. Results Compared with controls, glucocorticoid users demonstrated lower femoral neck trabecular number (−50.3%, 1.12 [0.84–1.54] mm −1 versus 2.27 [1.88–2.73] mm −1 , P = 0.02), plate‐to‐rod ratio (−20.1%, 1.48 [1.39–1.71] versus 1.86 [1.76–2.20], P = 0.03), and elastic modulus (−64.8% to −74.8%, 1.54 [1.22–3.19] GPa to 2.31 [1.87–4.44] GPa versus 6.15 [5.00–7.09] GPa to 6.59 [5.58–7.31] GPa, P < 0.05), and higher femoral neck trabecular separation (+192%, 0.705 [0.462–1.00] mm versus 0.241 [0.194–0.327] mm, P = 0.02). There were no differences in femoral neck trabecular thickness (−2.7%, 0.193 [0.184–0.217] mm versus 0.199 [0.179–0.210] mm, P = 0.94) or femoral neck BMD T‐scores (+20.7%, −2.1 [−2.8 to −1.4] versus −2.6 [−3.3 to −2.5], P = 0.24) between groups. Conclusion The 3T MRI can potentially detect detrimental changes in proximal femur microarchitecture and strength in long‐term glucocorticoid users. J. MAGN. RESON. IMAGING 2015;42:1489–1496.