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Impact microindentation: Consistency of serial measurements and alterations in patients with Paget's disease of the tibia: IMI: serial measurements
Impact microindentation is a new technique for the in vivo measurement of tissue-level properties of cortical bone in humans. To address issues related to the proper application of IMI in clinical practice and to directly examine cortical bone properties in patients with tibia pathology, we studied 11 subjects without tibia pathology and 9 patients with Paget's disease of the tibia in biochemical remission after bisphosphonate treatment. Serial indentations in the tibiae of both legs were performed in all subjects by a single operator until 10 adequate measurements were obtained in each tibia. In patients without Paget's disease [7 men and 4 women; mean age 61.9 years (range 51 - 72 years)], there was no difference in mean Bone Material Strength index (BMSi) between the dominant and non-dominant leg (82.1 ± 1.3 and 81.4 ± 1.3, respectively; p = 0.606). In each individual subject studied, sequential indentations in both legs showed no trends for higher or lower values with time. The standard deviation of unnormalized Bone Material Strength (BMSu) was also comparable between the dominant and non-dominant tibia (5.3 and 4.5, respectively; p = 0.657). In patients with Paget's disease [4 men and 5 women; mean age 69.5 years (range 55 - 87 years)], mean BMSi of the Pagetic tibia was lower, albeit non-significantly, than that of the contralateral non-affected tibia (74.7 ± 1.7 and 78.7 ± 1.3, respectively; p = 0.120). In contrast to subjects without Paget's disease, the SD of adequate BMSu values was significantly larger in the Pagetic tibia compared to that of the non-Pagetic tibia (7.6 vs. 5.0, respectively, p = 0.008). These results highlight the consistency of serial IMI measurements as performed by a single operator in the presence as well as absence of tibia pathology and illustrate that the method is able to capture alterations of tissue-level cortical bone properties in patients with Paget's disease of the tibia.
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- Malgo, F.; Hamdy, N.A.T.; Papapoulos, S.E.; Appelman-Dijkstra, N.M.
- Date
- 2017