Rib cortical bone thickness variation in adults by age and sex
dc.contributor.author | Holcombe, Sven A. | |
dc.contributor.author | Derstine, Brian A. | |
dc.date.accessioned | 2022-12-05T16:40:58Z | |
dc.date.available | 2024-01-05 11:40:47 | en |
dc.date.available | 2022-12-05T16:40:58Z | |
dc.date.issued | 2022-12 | |
dc.identifier.citation | Holcombe, Sven A.; Derstine, Brian A. (2022). "Rib cortical bone thickness variation in adults by age and sex." Journal of Anatomy (6): 1344-1356. | |
dc.identifier.issn | 0021-8782 | |
dc.identifier.issn | 1469-7580 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/175225 | |
dc.description.abstract | Rib fractures are a common and serious outcome of blunt thoracic trauma and their likelihood is greater in older individuals. Osteoporotic bone loss is a well-documented aging phenomenon with sex-specific characteristics, but within rib bones, neither baseline maps of regional thickness nor the rates of bone thinning with age have been quantified across whole ribs. This study presents such data from 4014 ribs of 240 adult subjects aged 20–90. A validated cortical bone mapping technique was applied to clinical computed tomography scans to obtain local rib cortical bone thickness measurements over the surfaces of ribs 2 through 11. Regression models to age and sex gave rates of cortex thinning in local zones and aggregated across whole ribs. The statistical parametric mapping provided these relationships regionally as a function of rib surface location. All models showed significant reductions in bone thickness with age (p < 0.01). Average whole-rib thinning occurred at between 0.011 to 0.032 mm/decade (males) and 0.035 to 0.043 mm/decade (females), with sex and age accounting for up to 37% of population variability (R2). Rates of thinning differed regionally and by rib, with the highest bone loss of up to 0.074 mm/decade occurring in mid-rib cutaneous and superior regions of ribs 2–6. Rates were consistently higher in females than males (significantly so across whole ribs but not all local regions) and were more pronounced in cutaneous, superior, and inferior rib aspects (average 0.025 mm/decade difference in ribs 4–8) compared to pleural aspects which had the thickest cortices but saw only minor differences in thinning rates by sex (0.045 mm/decade for females and 0.040 mm/decade for males). Regional analysis showed male and female bone thickness differences that were not statistically significant at 20 years of age (p > 0.05 across practically all regions) but subsequent cortex thinning meant that substantial pleural and cutaneous regions were thinner (p < 0.05) in females than males by 55 years of age. The techniques and results from this study can be applied to assess rib bone content loss in clinical settings across wide populations. Additionally, average cortex thickness results can be mapped directly to finite element models of the thorax, and regression results are used to modify such models to represent the ribs of men and women across their full adult lifespan.Cortex thickness was measured from 4K+ ribs in adult computed tomography scans to give detailed surface thickness maps across full rib cages. Whole ribs saw average cortex thinning rates of 0.022–0.045 mm/decade, with regional rates up to 0.075 mm/decade in cutaneous/superior regions. The thickest cortices (pleural aspect) did not see the highest rates of thinning, and men did not have thicker cortices than women except in oldest ages. Results can directly help human body modeling and inform clinical research. | |
dc.publisher | National Highway Traffic Safety Administration (NHTSA) | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.subject.other | computational models | |
dc.subject.other | computed tomography | |
dc.subject.other | cortical bone | |
dc.subject.other | cortical thickness | |
dc.subject.other | rib | |
dc.title | Rib cortical bone thickness variation in adults by age and sex | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Medicine (General) | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175225/1/joa13751_am.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175225/2/joa13751.pdf | |
dc.identifier.doi | 10.1111/joa.13751 | |
dc.identifier.source | Journal of Anatomy | |
dc.identifier.citedreference | Pipkorn, B., Iraeus, J., Lindkvist, M., Puthan, P. & Bunketorp, O. ( 2020 ) Occupant injuries in light passenger vehicles—a NASS study to enable priorities for development of injury prediction capabilities of human body models. Accident Analysis & Prevention, 138, 105443. Available from: https://doi.org/10.1016/j.aap.2020.105443 | |
dc.identifier.citedreference | Iraeus, J., Lundin, L., Storm, S., Agnew, A., Kang, Y.-S., Kemper, A. et al. ( 2019 ) Detailed subject-specific FE rib modeling for fracture prediction. Traffic Injury Prevention, 20, S88 – S95. Available from: https://doi.org/10.1080/15389588.2019.1665649 | |
dc.identifier.citedreference | Kemper, A.R., McNally, C., Kennedy, E.A., Manoogian, S.J., Rath, A.L., Ng, T.P. et al. ( 2005 ) Material properties of human rib cortical bone from dynamic tension coupon testing. Stapp Car Crash Journal, 49, 199 – 230. | |
dc.identifier.citedreference | Kemper, A.R., McNally, C., Pullins, C.A., Freeman, L.J., Duma, S.M. & Rouhana, S.M. ( 2007 ) The biomechanics of human ribs: material and structural properties from dynamic tension and bending tests. Stapp Car Crash Journal, 51, 235 – 273. | |
dc.identifier.citedreference | Kemper, A.R., Stitzel, J.D., McNally, C., Gabler, H.C. & Duma, S.M. ( 2009 ) Biomechanical response of the human clavicle: the effects of loading direction on bending properties. Journal of Applied Biomechanics, 25, 165 – 174. Available from: https://doi.org/10.1123/jab.25.2.165 | |
dc.identifier.citedreference | Li, Z., Kindig, M., Subit, D. & Kent, R. ( 2010 ) Development of finite element model of 50th percentile male using multiblock hex meshing approach. In: 38th Proceedings of the 6th annual world congress on biomechanics. Washington, DC: National Highway Traffic Safety Administration (NHTSA). https://www-nrd.nhtsa.dot.gov/database/bio/proceedings/search.asp | |
dc.identifier.citedreference | Mohr, M., Abrams, E., Engel, C., Long, W.B. & Bottlang, M. ( 2007 ) Geometry of human ribs pertinent to orthopedic chest-wall reconstruction. Journal of Biomechanics, 40, 1310 – 1317. Available from: https://doi.org/10.1016/j.jbiomech.2006.05.017 | |
dc.identifier.citedreference | Murach, M.M., Kang, Y.-S., Goldman, S.D., Schafman, M.A., Schlecht, S.H., Moorhouse, K. et al. ( 2017 ) Rib geometry explains variation in dynamic structural response: potential implications for frontal impact fracture risk. Annals of Biomedical Engineering, 45, 2159 – 2173. Available from: https://doi.org/10.1007/s10439-017-1850-4 | |
dc.identifier.citedreference | Palanca, M., Liebsch, C., Hübner, S., Marras, D., Ruspi, M.L., Marconi, F. et al. ( 2022 ) Global and local characterization explains the different mechanisms of failure of the human ribs. Journal of the Mechanical Behavior of Biomedical Materials, 125, 104931. Available from: https://doi.org/10.1016/j.jmbbm.2021.104931 | |
dc.identifier.citedreference | Pignolo, R.J., Law, S.F. & Chandra, A. ( 2021 ) Bone aging, cellular senescence, and osteoporosis. JBMR Plus, 5, e10488 Available from: https://doi.org/10.1002/jbm4.10488 | |
dc.identifier.citedreference | Poole, K.E.S., Treece, G.M., Mayhew, P.M., Vaculík, J., Dungl, P., Horák, M. et al. ( 2012 ) Cortical thickness mapping to identify focal osteoporosis in patients with hip fracture. PLoS One, 7, e38466. Available from: https://doi.org/10.1371/journal.pone.0038466 | |
dc.identifier.citedreference | Safarini, O.A. & Bordoni, B. ( 2022 ) Anatomy, thorax, ribs. StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK538328/ | |
dc.identifier.citedreference | Schoell, S.L., Weaver, A.A., Vavalle, N.A. & Stitzel, J.D. ( 2015 ) Age- and sex-specific thorax finite element model development and simulation. Traffic Injury Prevention, 16, S57 – S65. Available from: https://doi.org/10.1080/15389588.2015.1005208 | |
dc.identifier.citedreference | Shi, X., Cao, L., Reed, M.P., Rupp, J.D., Hoff, C.N. & Hu, J. ( 2014 ) A statistical human rib cage geometry model accounting for variations by age, sex, stature and body mass index. Journal of Biomechanics, 47, 2277 – 2285. Available from: https://doi.org/10.1016/j.jbiomech.2014.04.045 | |
dc.identifier.citedreference | Sirmali, M., Türüt, H., Topçu, S., Gülhan, E., Yazici, U., Kaya, S. et al. ( 2003 ) A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. European Journal of Cardio-Thoracic Surgery, 24, 133 – 138. | |
dc.identifier.citedreference | Sozen, T., Ozisik, L. & Calik Basaran, N. ( 2017 ) An overview and management of osteoporosis. European Journal of Rheumatology, 4, 46 – 56. Available from: https://doi.org/10.5152/eurjrheum.2016.048 | |
dc.identifier.citedreference | Stawicki, S.P., Grossman, M.D., Hoey, B.A., Miller, D.L. & Reed, J.F. ( 2004 ) Rib fractures in the elderly: a marker of injury severity. Journal of the American Geriatrics Society, 52, 805 – 808. Available from: 10. 1111/j.1532-5415. 2004.52223.x | |
dc.identifier.citedreference | Talbot, B.S., Gange, C.P., Chaturvedi, A., Klionsky, N., Hobbs, S.K. & Chaturvedi, A. ( 2017 ) Traumatic rib injury: patterns, imaging pitfalls, complications, and treatment. Radiographics, 37, 628 – 651. Available from: https://doi.org/10.1148/rg.2017160100 | |
dc.identifier.citedreference | Telfer, S., Brunnquell, C.L., Allen, J.D., Linnau, K.F., Zamora, D. & Kleweno, C.P. ( 2021 ) The effect of age and sex on pelvic bone density measured opportunistically in clinical CT scans. Journal of Orthopaedic Research, 39, 485 – 492. Available from: https://doi.org/10.1002/jor.24792 | |
dc.identifier.citedreference | Treece, G.M. & Gee, A.H. ( 2015 ) Independent measurement of femoral cortical thickness and cortical bone density using clinical CT. Medical Image Analysis, 20, 249 – 264. Available from: https://doi.org/10.1016/j.media.2014.11.012 | |
dc.identifier.citedreference | Vavalle, N.A., Schoell, S.L., Weaver, A.A., Stitzel, J.D. & Gayzik, F.S. ( 2014 ) Application of radial basis function methods in the development of a 95th percentile male seated FEA model. Stapp Car Crash Journal, 58, 361 – 384. | |
dc.identifier.citedreference | Witt, C.E. & Bulger, E.M. ( 2017 ) Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma Surgery & Acute Care Open, 2, e000064. Available from: https://doi.org/10.1136/tsaco-2016-000064 | |
dc.identifier.citedreference | Worsley, K., Taylor, J., Carbonell, F., Chung, M., Duerden, E., Bernhardt, B. et al. ( 2009 ) SurfStat: a Matlab toolbox for the statistical analysis of univariate and multivariate surface and volumetric data using linear mixed effects models and random field theory. NeuroImage, 47, S102. Available from: https://doi.org/10.1016/S1053-8119(09)70882-1 | |
dc.identifier.citedreference | Agnew, A.M., Schafman, M., Moorhouse, K., White, S.E. & Kang, Y.-S. ( 2015 ) The effect of age on the structural properties of human ribs. Journal of the Mechanical Behavior of Biomedical Materials, 41, 302 – 314. Available from: https://doi.org/10.1016/j.jmbbm.2014.09.002 | |
dc.identifier.citedreference | Agnew, A.M., Murach, M.M., Dominguez, V.M., Sreedhar, A., Misicka, E., Harden, A. et al. ( 2018 ) Sources of variability in structural bending response of pediatric and adult human ribs in dynamic frontal impacts. Stapp Car Crash Journal, 62, 119 – 192. | |
dc.identifier.citedreference | Alswat, K.A. ( 2017 ) Gender disparities in osteoporosis. Journal of Clinical Medicine Research, 9, 382 – 387. Available from: https://doi.org/10.14740/jocmr2970w | |
dc.identifier.citedreference | Chen, H. ( 2014 ) Bone three-dimensional microstructural features of the common osteoporotic fracture sites. World Journal of Orthopedics, 5, 486 – 495. Available from: https://doi.org/10.5312/wjo.v5.i4.486 | |
dc.identifier.citedreference | Chen, H., Poulard, D., Forman, J., Crandall, J. & Panzer, M.B. ( 2018 ) Evaluation of geometrically personalized THUMS pedestrian model response against sedan–pedestrian PMHS impact test data. Traffic Injury Prevention, 19, 542 – 548. Available from: https://doi.org/10.1080/15389588.2018.1450979 | |
dc.identifier.citedreference | Choi, H.-Y. & Kwak, D.-S. ( 2011 ) Morphologic characteristics of korean elderly rib. Journal of Automotive Safety and Energy, 2, 112 – 127. | |
dc.identifier.citedreference | De Troyer, A., Kirkwood, P.A. & Wilson, T.A. ( 2005 ) Respiratory action of the intercostal muscles. Physiological Reviews, 85, 717 – 756. Available from: https://doi.org/10.1152/physrev.00007.2004 | |
dc.identifier.citedreference | Dogrul, B.N., Kiliccalan, I., Asci, E.S. & Peker, S.C. ( 2020 ) Blunt trauma related chest wall and pulmonary injuries: an overview. Chinese Journal of Traumatology, 23, 125 – 138. Available from: https://doi.org/10.1016/j.cjtee.2020.04.003 | |
dc.identifier.citedreference | Eftekhar-Sadat, B., Ghavami, M., Toopchizadeh, V. & Ghahvechi Akbari, M. ( 2016 ) Wrist bone mineral density utility in diagnosing hip osteoporosis in postmenopausal women. Therapeutic Advances in Endocrinology and Metabolism, 7, 207 – 211. Available from: https://doi.org/10.1177/2042018816658164 | |
dc.identifier.citedreference | Folch-Fortuny, A., Arteaga, F. & Ferrer, A. ( 2016 ) Missing data imputation toolbox for MATLAB. Chemometrics and Intelligent Laboratory Systems, 154, 93 – 100. Available from: https://doi.org/10.1016/j.chemolab.2016.03.019 | |
dc.identifier.citedreference | Forman, J., Poplin, G.S., Shaw, C.G., McMurry, T.L., Schmidt, K., Ash, J. et al. ( 2019 ) Automobile injury trends in the contemporary fleet: belted occupants in frontal collisions. Traffic Injury Prevention, 20, 607 – 612. Available from: https://doi.org/10.1080/15389588.2019.1630825 | |
dc.identifier.citedreference | Gee, A.H. & Treece, G.M. ( 2014 ) Systematic misregistration and the statistical analysis of surface data. Medical Image Analysis, 18, 385 – 393. Available from: https://doi.org/10.1016/j.media.2013.12.007 | |
dc.identifier.citedreference | Holcombe, S.A., Wang, S.C. & Grotberg, J.B. ( 2017 ) The effect of age and demographics on rib shape. Journal of Anatomy, 231, 229 – 247. Available from: https://doi.org/10.1111/joa.12632 | |
dc.identifier.citedreference | Holcombe, S.A., Hwang, E., Derstine, B.A. & Wang, S.C. ( 2018 ) Measuring rib cortical bone thickness and cross section from CT. Medical Image Analysis, 49, 27 – 34. Available from: https://doi.org/10.1016/j.media.2018.07.003 | |
dc.identifier.citedreference | Holcombe, S.A., Kang, Y., Derstine, B.A., Wang, S.C. & Agnew, A.M. ( 2019 ) Regional maps of rib cortical bone thickness and cross-sectional geometry. Journal of Anatomy, 235, 883 – 891. Available from: https://doi.org/10.1111/joa.13045 | |
dc.identifier.citedreference | Holcombe, S.A., Kang, Y.-S.S., Wang, S.C. & Agnew, A.M. ( 2019 ) The accuracy of local rib bone geometry measurement using full body CT images. International Research Council on the Biomechanics of Injury, 19, 64. | |
dc.identifier.citedreference | Holcombe, S.A., Agnew, A.M., Derstine, B. & Wang, S.C. ( 2020 ) Comparing FE human body model rib geometry to population data. Biomechanics and Modeling in Mechanobiology, 19, 2227 – 2239. Available from: https://doi.org/10.1007/s10237-020-01335-2 | |
dc.identifier.citedreference | Hwang, E., Hu, J. & Reed, M.P. ( 2020 ) Validating diverse human body models against side impact tests with post-mortem human subjects. Journal of Biomechanics, 98, 109444. Available from: https://doi.org/10.1016/j.jbiomech.2019.109444 | |
dc.working.doi | NO | en |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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