Work

Correlation of opportunistic bone mineral density assessment derived from CT images with physical functioning in long-term follow-up in patients with rib fractures

Year: 2026

Type: article

Abstract: Objective Quality of life assessment is strictly related to patients physical functioning. Despite the fact that earlier research has concentrated on the role of osteoporosis, the question of whether opportunistic bone mineral density (BMD) assessment can assist in determining physical functioning remains unresolved. This exploratory analysis aims to elucidate whether the opportunistic BMD assessment defined by computed tomography (CT) images is associated with quality of life in long-term follow-up in patients with traumatic rib fractures. Methods All patients had rib fractures without polytrauma. A total of 72 patients, including 27 female patients (37.5%), with a median age of 60 years, were included in the present study. Contrast-enhanced CT imaging was obtained and vertebral trabecular attenuation in HU at Th12 level was measured. CT scans were perfomed using a tube voltage of 120 kVp. Quality of life was assessed using the Short Form 36-Item Health Survey (SF-36) no earlier than four years after trauma. Results Opportunistically measured BMD obtained at 120 kVp showed a moderate correlation with the physical functioning (PF) with a r = 0.43 ( p ≤ 0.001). The severely impaired PF group showed a significantly lower level of vertebral trabecular attenuation with a median value of 118 HU compared to 172 HU of the non-impaired group ( p = 0.004). CT-derived BMD showed a moderate predictive ability for severely impaired PF (AUC = 0.78) with a cut-off level of 132 HU. Conclusion CT-derived opportunistic BMD measurement at Th12 level is correlated with severe physical functioning impairment in patients with rib fractures in long-term follow-up. The potential role of CT images in patients with traumatic rib fractures, beyond diagnostic purposes, needs further assessment.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2026.1911891