The trabecular bone score is a measure of bone texture correlated with bone microarchitecture and markers for the risk of osteoporosis. Introduced in 2008, its principal projected use is along bone density measures in predicting better fracture risk in people with metabolic bone problems.
Video Trabecular bone score
Need for microarchitecture marker
To diagnose osteoporosis, despite the inclusion of bone mineral density (BMD), biological markers and clinical risk factors for fractures, many undetectable patients are at risk and many fractures are not described. bone mineral density is an assessment of bone quantity. It does not provide information about bone quality, another important parameter for describing bones. In addition, clinical risk factors for fractures are at least an indirect assessment of bone quality. One way to describe bone quality is to assess its microstructure. Bone microarchitecture is associated with bone mechanical strength and therefore the risk of fracture is greater or less. Indeed, for the same amount of bone, a mechanically resistant bone structure may be present (some large trabeculae or many more mechanically stronger trabeculae). In fact, bone loss is often accompanied by damage to bone architecture, resulting in decreased trabeculae, increased inter-trabecular distance, and loss of trabecular meshwork connectivity. In addition, reduced cortical bone thickness and increased porosity accompany trabecular bone loss, and in particular increase the fragility of the femoral neck. The bone of osteoporosis is called "porous".
Maps Trabecular bone score
Technical
The trabecular bone score is a textural parameter that can be applied to DEXA, which quantifies local variations in gray levels. TBS is derived from an experimental variogram evaluation, obtained from DEXA grayscale.
It was found that TBS is a reflection of the structural conditions of the bone microarchitecture. TBS is strongly correlated with the number of trabeculae and its connectivity and negatively with the space between the trabeculae. The point is that high TBS values ​​mean solid microbial architecture, well connected with little space between trabeculae. In contrast, low TBS values ​​mean that bone microarchitecture is incomplete and less connected to wide space between trabeculae.
Clinical use
From a clinical point of view, TBS provides:
- assesses the risk of fracture;
- in combination with BMD, increasing the number of patients at risk (identified correctly);
- improves the management of patients with secondary osteoporosis;
- follow-up evolution of the microarchitecture of patients over time;
- monitoring of anti-resorptive or anabolic effects.
All of these studies have shown that FFB can be used as a clinical risk factor for osteoporotic fractures because it is reversible (with or without treatment), quantitative and independent of BMD. It should therefore be used in the same way as taking corticosteroids, rheumatoid arthritis or general fractures after the age of 50 years.
Notes and references
Source of the article : Wikipedia
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