Postmenopausal osteoporosis: simple screening method for diagnosis before structural failure.

Concurrent measurements of combined cortical thickness (CCT) at the midshaft of the second metacarpal and at the proximal juxtametaphyseal radial cortex were made in 234 healthy women aged 46-80 years (group 1) and in 52 women with symptomatic osteoporosis (at least two spontaneous vertebral compressions) (group 2). When -2 standard deviations (SDs) of the mean values in young healthy women (aged 21-45 years) were used as the lower limit of normal measurements, 47% of the subjects in group 1 showed abnormalities: in 25% both bones were abnormal, in 12% the radius alone was abnormal, and in 10% the second metacarpal alone was abnormal. Because 98% of the subjects in group 2 had abnormal CCT measurements, the -2-SD limit of the younger healthy subjects appears to constitute a satisfactory "fracture threshold.

Longitudinal microradioscopic comparisons on endosteal and juxtaendosteal bone loss in premenopausal and postmenopausal women, and in those with end-stage renal disease.

Endosteal bone resorption is the principal mechanism of bone loss in involutional osteoporosis and in renal osteodystrophy. In the cortical bone it is often accompanied by juxtaendostal bone resorption. Using fine-detail radiographs and x6 magnified viewing, longitudinal radiographic observations and measurements were made on these two forms of bone resorption in the metacarpals II, III, and IV in three groups of women: (1) premenopausal, (2) postmenopausal, and (3) patients with end-stage renal disease.

Quantitative radionuclide scanning in metabolic bone disease.

A simple method of quantifying skeletal uptake of 99Tcm-methylene diphosphonate, using a rectilinear scanner and a simultaneously image standard, is described. The pattern of quantified uptake in ten regions of the skeleton, the sacro-iliac joints and kidneys in 57 controls and 54 patients with various metabolic bone disease is presented. This method distinguishes patients with primary hyperparathyroidism and osteomalacia from controls with a sensitivity adequate for clinical purposes.

Evaluation of cortical bone mass, thickness and density by z-scores in osteopenic conditions and in relation to menopause and estrogen treatment.

Z-scores express differences from normals in standard deviation units, and are particularly useful for comparison of changes where normal values are age- and sex-dependent. We determined z-scores for bone mineral mass, cortical thickness, and bone mineral density in the radius in various conditions and diseases in both sexes. In the males, z-scores were calculated for age, but in the females z-scores for menopausal status (years postmenopausal exclusive of years on estrogen treatment) were found to be more appropriate.