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Journal of Osteoporosis
Volume 2012, Article ID 519754, 7 pages
Clinical Study

Bone Mineral Density in Spinal Cord Injury: An Evaluation of the Distal Femur

1Physical Medicine and Rehabilitation Division, Federal University of São Paulo, São Paulo, SP, Brazil
2Physical Medicine and Rehabilitation Division, Albert Einstein Hospital, São Paulo, SP, Brazil
3Endocrinology Division, Federal University of São Paulo, São Paulo, SP, Brazil

Received 15 June 2012; Accepted 9 July 2012

Academic Editor: Osvaldo Daniel Messina

Copyright © 2012 Alexandra Passos Gaspar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Osteoporosis (OP) in spinal cord injury (SCI) patients is a secondary process in which numerous factors are involved. Diagnosing OP and the threshold for fractures in this population, based on bone mineral density (BMD) measured by double energy X-ray absorptiometry (DXA), is still a challenge. The aim of this study was to evaluate bone mineral loss by DXA, its relationship with body composition and fracture incidence, in complete paraplegics patients, compared with aged-matched controls; we include a nonstandard bone site, the distal femur, and describe the technical and practical aspects of this procedure. Twenty-five SCI patients were included in the study and 17 subjects as control group. No prior or recent fractures were observed in X-ray analysis. The BMD of all femoral sites was significantly lower in patients than in controls (femoral neck, total femur, and distal femur); no difference was observed between BMD of the lumbar spine of patients and controls. We found inverse relationship between time of SCI and bone mineral mass only for distal femur BMD. We conclude that the distal femur is a more sensitive bone site for assessing bone loss by DXA, in SCI patients, than the proximal femoral sites.