Proximal femur ct scans of british postmenopausal women show that bone loss is tissue dependent

Fragility fractures pose a massive healthcare burden worldwide. Low bone quality is a major determinant of fracture risk. Bone strength, using computed-tomography based subject-specific finite-element (CT-SSFE) analysis, estimates bone quality more accurately than dual-energy X ray absorptiometry based areal bone mineral density (DXA-aBMD). Yet, longitudinal data – a requirement for computing long-term fracture risk – is challenging to obtain using CT but not using DXA-aBMD. To overcome this challenge, a model for estimating the rate of change of vBMD with aBMD is developed in this study based on CT and DXA-aBMD data measured in a cohort of postmenopausal women at risk of fracture.