271784
Normal Values of Regional Bone Density within the Foot for Community Dwelling Caucasian Women in the US
Tuesday, October 30, 2012
: 9:10 AM - 9:30 AM
Adam Fleischer, DPM, MPH
,
Department of Podiatric Medicine & Radiology, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University, North Chicago, IL
Osteoporosis (OP) is a major public health threat for 44 million Americans, sixty-eight percent of which are women. Foot and ankle providers can play an important role in OP detection by identifying at-risk patients and referring them on for formal bone densitometry testing early. The aim of this study was to establish age-related normal values for several indices which are commonly used to describe bone mineral density in the foot using a high risk population. Radiographs of 180 healthy, Caucasian females (ages 20-79, stratified by decade) attending a large Chicago-area outpatient podiatry clinic from 1998 to 2005 were randomly selected and retrospectively reviewed. The lesser metatarsals on anterior-posterior (AP) foot radiographs were evaluated for combined cortical thickness (CCT), percent cortical area (PCA), and for the presence of prominent primary trabeculations (PPT) and intracortical striations (IS). The calcaneus was evaluated using Jhamaria's Calcaneal Index on lateral radiographs. There were 139 patients with the full compliment of radiographic and chart data. All indices were found to be sensitive to the effects of aging (p<0.05) and all demonstrated acceptable inter- and intra-rater reliability (e.g., moderate to excellent agreement or CV less than 0.10). Establishing a set of normal values and ranges for pedal radiographic indices of bone density may help foot and ankle providers to better identify women at risk for osteoporosis and osteoporotic fracture. These radiographic norms may also have value in the pre-operative assessment of bone quality in surgical patients.
Learning Areas:
Basic medical science applied in public health
Public health or related organizational policy, standards, or other guidelines
Learning Objectives: Identify age-related normal values for several indices which are commonly used to describe bone mineral density in the foot using a high risk population.
Keywords: Women's Health, Screening
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a podiatrist and instructor at the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University. I am actively involved in the training of podiatric surgical residents. My clinical interests include all aspects of elective and non-elective foot and ankle surgery. My publications, teaching and research interests focus on musculoskeletal imaging (specifically MRI and ultrasound), evidenced-based medicine, diabetic foot care/limb preservation and surgical outcomes.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
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