The Experts below are selected from a list of 153 Experts worldwide ranked by ideXlab platform
Alexander Pfeil - One of the best experts on this subject based on the ideXlab platform.
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Differing X-ray patterns in seronegative and seropositive rheumatoid arthritis
Clinical Rheumatology, 2019Co-Authors: Ottar Gadeholt, Katharina Hausotter, Hannes Eberle, Thorsten Klink, Alexander PfeilAbstract:Introduction Anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF) status are important predictors for rheumatoid arthritis (RA) erosivity. Qualitative differences on hand/feet radiographs have been described, indicating more carpal fusion in seronegative RA. This study explores these differences further using the total Sharp/van der Heijde score (TSS), digital X-ray radiogrammetry (DXR), and qualitative description. Methods and materials Matched seronegative (ACPA negative, RF negative, snRA) and seropositive (ACPA, RF > 3xULN, spRA) were examined. TSS scores both for erosions and joint space narrowing (JSN) were registered separately and compared for both groups. Joint compartments and single joints were compared, using a heat map. The degree of carpal fusion was quantified 0–5. DXR measurements (Bone mineral density, Cortical Thickness, Bone width, metacarpal index) were determined for each hand separately. Finally, selected radiographs were examined unblinded to search for non-quantifiable differences. Results A total of 56 snRA and 57 spRA patients were examined. spRA patients had more erosions and joint space narrowing. Erosion load differed significantly between spRA and snRA in the foot and metacarpophalangeal joint, but not in the wrist or proximal interphalangeal joint compartments. Intracompartmental differences were greater in spRA. JSN scores were greater in spRA, in all compartments except wrist. Carpal fusion and DXR scores did not differ between the groups. The qualitative comparison showed that snRA patients displayed periarticular ossifications, carpal shortening, and sparing of the CMC joints, whereas spRA patients had more CMC damage and less shortening. Conclusion X-ray manifestations in snRA and spRA are qualitatively and quantitatively different. This suggests pathophysiological differences between the two forms. Key Points • Seronegative and seropositive RA display qualitatively and quantitatively different X-ray patterns, suggesting differences in the underlying pathophysiological process. This is the first time that this has been shown in a systematic, quantitative fashion .
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Differing X-ray patterns in seronegative and seropositive rheumatoid arthritis.
Clinical rheumatology, 2019Co-Authors: Ottar Gadeholt, Katharina Hausotter, Hannes Eberle, Thorsten Klink, Alexander PfeilAbstract:Anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF) status are important predictors for rheumatoid arthritis (RA) erosivity. Qualitative differences on hand/feet radiographs have been described, indicating more carpal fusion in seronegative RA. This study explores these differences further using the total Sharp/van der Heijde score (TSS), digital X-ray radiogrammetry (DXR), and qualitative description. Matched seronegative (ACPA negative, RF negative, snRA) and seropositive (ACPA, RF > 3xULN, spRA) were examined. TSS scores both for erosions and joint space narrowing (JSN) were registered separately and compared for both groups. Joint compartments and single joints were compared, using a heat map. The degree of carpal fusion was quantified 0–5. DXR measurements (Bone mineral density, Cortical Thickness, Bone width, metacarpal index) were determined for each hand separately. Finally, selected radiographs were examined unblinded to search for non-quantifiable differences. A total of 56 snRA and 57 spRA patients were examined. spRA patients had more erosions and joint space narrowing. Erosion load differed significantly between spRA and snRA in the foot and metacarpophalangeal joint, but not in the wrist or proximal interphalangeal joint compartments. Intracompartmental differences were greater in spRA. JSN scores were greater in spRA, in all compartments except wrist. Carpal fusion and DXR scores did not differ between the groups. The qualitative comparison showed that snRA patients displayed periarticular ossifications, carpal shortening, and sparing of the CMC joints, whereas spRA patients had more CMC damage and less shortening. X-ray manifestations in snRA and spRA are qualitatively and quantitatively different. This suggests pathophysiological differences between the two forms.
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry
Osteoporosis International, 2008Co-Authors: M.-l. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. Introduction The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Methods Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. Results The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). Conclusions The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry.
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteopor, 2008Co-Authors: M. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Normative Data for Digital X-Ray Radiogrammetry From a Female and Male German Cohort
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry, 2006Co-Authors: Joachim Böttcher, M. Schäfer, Alexander Pfeil, Gabriele Lehmann, Alexander Petrovitch, B. E. Seidl, Hans-joachim Mentzel, Ansgar Malich, J. P. Heyne, Gert HeinAbstract:This study presents German reference data for digital X-ray radiogrammetry (DXR) differentiated by males as well as females, and quantifies for gender-specific and age-related differences including all DXR parameters. This study also documents the effects of different X-ray settings (e.g., radiographs of the wrist or the hand) on DXR measurements. There were 2085 patients who were prospectively enrolled (954 females and 1131 males) from a data pool of 11,915 patients with radiographs of the nondominant hand or wrist. All patients underwent measurements of Bone mineral density (BMD), Cortical Thickness, Bone width, and the metacarpal index (MCI) using DXR technology. These data showed a continuous age-related increase of the DXR parameters to the point of peak Bone mass, then a continuous decline beyond the peak Bone mass with accentuated age-related Cortical Bone loss in women. Peak Bone mass is reached at approximately 30-34 yr for women and 45-49 yr for men. In addition, men had a significantly higher DXR BMD (mean: +12.8%) compared with woman in all age groups. Regarding the impact of various X-ray settings (e.g., X-ray(wrist) vs. X-ray(hand)), no significant difference was observed between both groups, men as well as women. The development of digital imaging technology has enabled more precise measurements of several radio-geometric features. The present study estimated normative reference values for DXR in German Caucasian women and men. Based on this reference data, a valid and reliable quantification of disease-related demineralization based on measurements of DXR BMD and MCI is now available for the Caucasian ethnic group.
Joachim Böttcher - One of the best experts on this subject based on the ideXlab platform.
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry
Osteoporosis International, 2008Co-Authors: M.-l. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. Introduction The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Methods Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. Results The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). Conclusions The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry.
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteopor, 2008Co-Authors: M. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Normative Data for Digital X-Ray Radiogrammetry From a Female and Male German Cohort
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry, 2006Co-Authors: Joachim Böttcher, M. Schäfer, Alexander Pfeil, Gabriele Lehmann, Alexander Petrovitch, B. E. Seidl, Hans-joachim Mentzel, Ansgar Malich, J. P. Heyne, Gert HeinAbstract:This study presents German reference data for digital X-ray radiogrammetry (DXR) differentiated by males as well as females, and quantifies for gender-specific and age-related differences including all DXR parameters. This study also documents the effects of different X-ray settings (e.g., radiographs of the wrist or the hand) on DXR measurements. There were 2085 patients who were prospectively enrolled (954 females and 1131 males) from a data pool of 11,915 patients with radiographs of the nondominant hand or wrist. All patients underwent measurements of Bone mineral density (BMD), Cortical Thickness, Bone width, and the metacarpal index (MCI) using DXR technology. These data showed a continuous age-related increase of the DXR parameters to the point of peak Bone mass, then a continuous decline beyond the peak Bone mass with accentuated age-related Cortical Bone loss in women. Peak Bone mass is reached at approximately 30-34 yr for women and 45-49 yr for men. In addition, men had a significantly higher DXR BMD (mean: +12.8%) compared with woman in all age groups. Regarding the impact of various X-ray settings (e.g., X-ray(wrist) vs. X-ray(hand)), no significant difference was observed between both groups, men as well as women. The development of digital imaging technology has enabled more precise measurements of several radio-geometric features. The present study estimated normative reference values for DXR in German Caucasian women and men. Based on this reference data, a valid and reliable quantification of disease-related demineralization based on measurements of DXR BMD and MCI is now available for the Caucasian ethnic group.
Richard A Robb - One of the best experts on this subject based on the ideXlab platform.
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relation of vertebral deformities to Bone density structure and strength
Journal of Bone and Mineral Research, 2010Co-Authors: Joseph L Melton, Lawrence B Riggs, Tony M Keaveny, Sara J Achenbach, David L Kopperdahl, Jon J Camp, Peggy A Rouleau, Shreyasee Amin, Elizabeth J Atkinson, Richard A RobbAbstract:Because they are not reliably discriminated by areal Bone mineral density (aBMD) measurements, it is unclear whether minimal vertebral deformities represent early osteoporotic fractures. To address this, we compared 90 postmenopausal women with no deformity (controls) with 142 women with one or more semiquantitative grade 1 (mild) deformities and 51 women with any grade 2–3 (moderate/severe) deformities. aBMD was measured by dual-energy X-ray absorptiometry (DXA), lumbar spine volumetric Bone mineral density (vBMD) and geometry by quantitative computed tomography (QCT), Bone microstructure by high-resolution peripheral QCT at the radius (HRpQCT), and vertebral compressive strength and load-to-strength ratio by finite-element analysis (FEA) of lumbar spine QCT images. Compared with controls, women with grade 1 deformities had significantly worse values for many Bone density, structure, and strength parameters, although deficits all were much worse for the women with grade 2–3 deformities. Likewise, these skeletal parameters were more strongly associated with moderate to severe than with mild deformities by age-adjusted logistic regression. Nonetheless, grade 1 vertebral deformities were significantly associated with four of the five main variable categories assessed: Bone density (lumbar spine vBMD), Bone geometry (vertebral apparent Cortical Thickness), Bone strength (overall vertebral compressive strength by FEA), and load-to-strength ratio (45-degree forward bending ÷ vertebral compressive strength). Thus significantly impaired Bone density, structure, and strength compared with controls indicate that many grade 1 deformities do represent early osteoporotic fractures, with corresponding implications for clinical decision making. © 2010 American Society for Bone and Mineral Research.
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A Bone structural basis for fracture risk in diabetes.
The Journal of clinical endocrinology and metabolism, 2008Co-Authors: L. Joseph Melton, Sara J Achenbach, Jon J Camp, Elizabeth J Atkinson, Richard A Robb, B. Lawrence Riggs, Cynthia L. Leibson, Mary L. Bouxsein, Sundeep KhoslaAbstract:Context: Elevated areal Bone mineral density (aBMD) in type 2 diabetes mellitus is inconsistent with increased fracture risk at some skeletal sites. Objectives: Because aBMD is an imperfect surrogate for Bone strength, we assessed Bone structure and strength more directly using quantitative computed tomography. Design: Diabetic and nondiabetic subjects were evaluated in a cross-sectional study. Setting: Subjects were recruited from a random sample of the Rochester, MN, population. Participants: Forty-nine subjects (28 women and 21 men) with type 2 diabetes were compared with age- and sex-matched nondiabetic controls. Main Outcome Measurements: We measured Bone geometry, strength, and volumetric BMD (vBMD) at the hip, spine, and wrist, along with hip aBMD, using central and peripheral quantitative computed tomography and estimated Bone load to Bone strength ratios at each site. Results: Adjusted for differences in body mass index between cases and controls (29.8 vs. 27.6), hip aBMD was greater in diabetic subjects, but this was accounted for by greater trabecular vBMD. Cortical vBMD was similar in the two groups, as was Bone cross-sectional area and Cortical Thickness. Bone strength measures were generally better in diabetic subjects, but Bone loads were higher from their greater weight. Consequently, load to strength ratios (i.e. factor-of-risk) were similar. Conclusions: Patients with type 2 diabetes enjoy little benefit from elevated aBMD in terms of improved Bone load to strength ratios. With no deficit in Bone density, the rationale for antiresorptive therapy in diabetic patients is uncertain, but potential adverse effects of diabetes on Bone quality need more study.
Gert Hein - One of the best experts on this subject based on the ideXlab platform.
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry
Osteoporosis International, 2008Co-Authors: M.-l. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. Introduction The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Methods Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. Results The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). Conclusions The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry.
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteopor, 2008Co-Authors: M. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
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Normative Data for Digital X-Ray Radiogrammetry From a Female and Male German Cohort
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry, 2006Co-Authors: Joachim Böttcher, M. Schäfer, Alexander Pfeil, Gabriele Lehmann, Alexander Petrovitch, B. E. Seidl, Hans-joachim Mentzel, Ansgar Malich, J. P. Heyne, Gert HeinAbstract:This study presents German reference data for digital X-ray radiogrammetry (DXR) differentiated by males as well as females, and quantifies for gender-specific and age-related differences including all DXR parameters. This study also documents the effects of different X-ray settings (e.g., radiographs of the wrist or the hand) on DXR measurements. There were 2085 patients who were prospectively enrolled (954 females and 1131 males) from a data pool of 11,915 patients with radiographs of the nondominant hand or wrist. All patients underwent measurements of Bone mineral density (BMD), Cortical Thickness, Bone width, and the metacarpal index (MCI) using DXR technology. These data showed a continuous age-related increase of the DXR parameters to the point of peak Bone mass, then a continuous decline beyond the peak Bone mass with accentuated age-related Cortical Bone loss in women. Peak Bone mass is reached at approximately 30-34 yr for women and 45-49 yr for men. In addition, men had a significantly higher DXR BMD (mean: +12.8%) compared with woman in all age groups. Regarding the impact of various X-ray settings (e.g., X-ray(wrist) vs. X-ray(hand)), no significant difference was observed between both groups, men as well as women. The development of digital imaging technology has enabled more precise measurements of several radio-geometric features. The present study estimated normative reference values for DXR in German Caucasian women and men. Based on this reference data, a valid and reliable quantification of disease-related demineralization based on measurements of DXR BMD and MCI is now available for the Caucasian ethnic group.
M.-l. Schäfer - One of the best experts on this subject based on the ideXlab platform.
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Effects of long-term immobilisation on Cortical Bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry
Osteoporosis International, 2008Co-Authors: M.-l. Schäfer, Alexander Pfeil, Diane M. Renz, Gabriele Lehmann, M. Schmidt, Andreas Hansch, Gert Hein, Gunter Wolf, Werner A. Kaiser, Joachim BöttcherAbstract:Osteopenia of the Cortical and trabecular Bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify Cortical demineralisation caused by circular saw amputation already few days after accident. Introduction The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of Bone mineral density estimated at the metacarpalia II–IV using DXR. Methods Twenty-eight patients with digital amputations underwent measurements of Bone mineral density, Cortical Thickness, Bone width and metacarpal index using DXR-technology in a follow-up up to 902 days. Results The data showed a significant decline of Bone mineral density (−10.47%), the metacarpal index (−4.38%), the Bone width (−12.06%) and the Cortical Thickness (−7.04%) after trauma-related amputation. The Cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (−3.65%). Conclusions The inhibition of the periosteal Bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) Bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).
