Back to 2026 Abstracts
Second Metacarpal Cortical Index Correctly Predicts Osteoporosis
Arman Tabarestani, BS
1, Marco Foreman, BS
1, Anton Khlopas, MD
2, Kevin Hao, MD
1, Keegan M Hones, MD
2, Thomas Wright, MD
1; Jongmin Kim, MD
2(1)University of Florida, Gainesville, FL, (2)University of Florida College of Medicine, Gainesville, FL
Introduction:Second metacarpal index (2MCI) is a quick and simple calculation obtained from hand or wrist radiographs that can be used by clinicians to screen for osteoporosis and target high risk patients. In this study, we investigate the relationship between the 2MCI and hip bone mineral density.
Methods:We conducted a retrospective review of 1080 patients aged 18-100 years old who received a Dual-Energy Xray Absorptiometry (DEXA) scan between January 1, 2004 and March 1, 2024, and had a hand or wrist radiograph within 1 year of their DEXA scan date. Patients were excluded if they did not have a 2
nd metacarpal (2MC), there was no clear view of the 2MC on radiograph, or if there was no mention of the femoral neck T-score in the DEXA report. Multivariable logistic regression and Pearson correlation coefficients were employed to determine the strength of the relationship between the 2MCI and femoral neck T-scores.
Results:1028 patient values were included in the study. Pearson correlation analysis demonstrated a moderate correlation between 2MCI and T-score from femur DEXA scan (
R=.40,
P<.001). Stratification by age, sex, and days between scans demonstrated a minor modifier effect. The mean time between hand radiographs and DEXA scans was 134 days (SD, 107 days). The mean 2MCI was 0.56 (SD, 0.11; range, 0.21 to 0.94). The mean DEXA femur T-score was -1.6 (SD, 1.1; range, -4.9 to 3.2). The AUC, sensitivity, and specificity of 2MCI density score for osteoporosis with a threshold value of 0.57 was .833, 82.2%, and 72.4% respectively.
Conclusions:Using the 2MCI based on hand or wrist radiographs offers a straightforward approach for osteoporosis screening, requiring minimal time and no specialized software or complex calculations. While DEXA scans remain the gold standard for diagnosing osteoporosis, this measurement may help orthopedic surgeons identify patients who should be referred to metabolic bone disease specialist for further assessment and management.
Back to 2026 Abstracts
