Application of high-resolution peripheral quantitative computed tomography in a clinical setting

HR-pQCT is a special CT-scanner that enables very detailed visualization and assessment of the bones in the lower arm and hand and in the lower leg and foot. The use of for example conventional CT, DXA, and X-ray does not enable evaluation of bones in the same amount of detail, therefore not always providing a complete impression of someone’s bone structure and bone strength and missing certain fractures. In this thesis, the application of HR-pQCT was investigated in patient care, specifically for several (rare) bone conditions, treatments of osteoporosis, and fractures. The use of HR-pQCT provided new insights into the bone structure and bone strength in adults with osteogenesis imperfecta and adults with stone man disease and into the effects of treatment with medication in two forms of secondary osteoporosis. Additionally, HR-pQCT improved the diagnosis of scaphoid fractures as compared to conventional CT. It could also be used to monitor the healing of scaphoid fractures and wrist fractures, which gave new insights into the healing process.