Fractal-Based Analysis of Bone Microstructure in Crohn’s Disease: A Pilot Study

Introduction Crohn’s disease is associated with bone loss and increased fracture risk. The TX-Analyzer is a new fractal-based technique assessing bone microstructure based on conventional radiographs. We evaluated bone microstructure of the thoracic and lumbar spine by TX-Analyzer in Crohn’s disease patients and controls and correlated outcome parameters to standard imaging techniques.

Methods 39 Crohn’s disease patients and 39 age- and gender-matched controls were analyzed. The parameters bone structure value, bone variance value and bone entropy value were measured at the vertebral bodies of T7 to L4 out of lateral radiographs. Furthermore, bone mineral density and trabecular bone score by dual energy X-ray absorptiometry were correlated to them. Crohn’s disease patients were further divided into subgroups according to history of glucocorticoid treatment>3 months, disease duration>15 years and history of bowel resection.

Results Bone structure value and bone variance value of the thoracic spine of Crohn’s disease patients were higher compared to controls (p=0.016, p=0.012). Bone entropy value was significantly lower in Crohn’s disease patients with glucocorticoid treatment>3 months (p=0,015) and disease duration>15 years (p=0.001) at the thoracic spine and with history of bowel resection at the lumbar spine (p=0.011), with no differences in bone mineral density between both subgroups. Additionally, trabecular bone score was reduced in patients with glucocorticoid treatment>3 months (p=0.014).

Discussion Despite a not severely pronounced bone loss in this population, impaired bone quality in Crohn’s disease patients with well-known risk factors for systemic bone loss was assessed by TX-Analyzer.

Keywords Crohn’s disease, TX-Analyzer, fractal-based analysis, bone microstructure, bone loss

Korrespondenzadresse Daniel Arian Kraus, Ludwig Boltzmann Institut für Osteologie, Heinrich-Collin-Straße 30, 1140 Wien, Österreich, E-Mail: [e-mail]

Publication History

Article published online:
08 September 2022