Article
External Validation of the 2nd Metacarpal Cortical Index As A Simple Screening Tool for Osteopenia
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Published: | February 6, 2020 |
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Objectives/Interrogation: Osteopenia, is a known risk factor for sustaining hand and wrist fractures. Secondary prevention of further fractures has obvious clinical and economic advantages; however screening all patients using a DEXA is unfeasible. We wished to externally assess the use of the 2nd metacarpal cortical index (2MCI), as a simple screening tool for identifying patients at high risk of having osteopenia, and requiring treatment.
Methods: We retrospectively collected radiographic data on 206 patients who had a simple radiograph of the hand and dual energy X-ray absorptiometry (DEXA) within one year of each other, and from our picture archiving and communication system (PACS) database. The 2MCI was calculated for all patients. As data was parametric, a Pearson's correlation was performed to assess for an association between T-scores and the 2MCI. Further analysis involved the construction of receiver operating characteristic curves (ROC) to identify a 2MCI index, which would give the most appropriate sensitivity and specificity for identifying the presence of osteopenia.
Results: There was a statistically significant and moderate correlation between DEXA T-scores and 2MCI values (r=0.54, n=206, p<0.001). Further ROC curve analysis of normal and osteopenic subjects identified that a 2MCI of 41.5 had a sensitivity of 100% and specificity of 53% for detecting osteopenia.
Conclusion: Our results support the use of the 2MCI as a simple screening tool for identifying patients at risk of osteopenia.