Utility of the Cortical Thickness of the Distal Radius as a Predictor of Distal-Radius Bone Density

Background: Bone density is an important factor in the management of fractures of the distal radius. Objectives: The aim of this study was to establish whether standard anteroposterior (AP) radiographs would provide the attending physician with a prediction of bone density. Patients and Methods: Six pairs of human cadaveric radii were harvested. The mean donor age was 74 years. Standardized AP radiographs were taken of the radii. The outside diameter and the inside diameter of the cortical shell at the metaphyseal / diaphyseal junction were measured and their ratio was calculated. Dual-energy x-ray absorptiometry (DXA) was used to obtain the bone mineral density (BMD) of the distal parts of the radii. The correlation of the BMD values with these ratios was studied. Results: The mean BMD was 0.559 (SD = 0.236) g / cm2. The mean outside diameter/inside diameter ratio was 1.24 (SD = 0.013); the ratio significantly correlated with the total BMD (P = 0.001; R2 = 0.710). In the BMD subregions, the correlation was also significant. Conclusions: The outside diameter/inside diameter ratio at the metaphyseal/diaphyseal junction of the distal radius on AP radiographs is suitable for use as a predictor of distal-radius bone density. Further studies should be performed, and clinical utility evaluated.