OBJECTIVE:The objective of the study was to investigate magnetic resonance imaging(MRI)findings of the upper respiratory tract(URT;a main harbor site for infection)in patients with coronavirus disease 2019(COVID-19),and their association with pneumonia severity. MATERIALS AND METHODS:URT MRI of 128 patients with confirmed COVID-19 was evaluated.URT lymphoid tissue hyperplasia as an overall score of adenoid mass,tonsil enlargement,and cervical adenopathy was analyzed,along with quantitative pneumonia data on chest computed tomography(CT). RESULTS:Effusion of the posterior laryngopharyngeal wall(98％)was the most common,followed by the nasopharyngeal(80％)and the posterior oropharyngeal(70％)walls.There was also evidence of(Ⅰ)swelling of the epiglottis(99％)and vocal cord(58％),(Ⅱ)mild or no(15％),moderate(42％),and severe(37％)nasopharyngeal roof thickness,(Ⅲ)mild(50％),moderate(21％),and severe(3％)tonsil enlargement,and(Ⅳ)mild(22％),moderate(54％),and severe(20％)cervical lymph node enlargement.Ethmoid sinusitis was the most common(98％),which was followed by maxillary sinusitis(81％).Mastoiditis was present in 32％of patients.At follow-up(n=22),nasopharyngeal wall thickening was improved in four patients.Chest CT images showed pneumonia in 57％of patients.There were also more focal adenoid masses,and tonsil and cervical lymph node enlargement.Furthermore,the URT lymphoid tissue hyperplasia scores were higher in patients without pneumonia than in those with pneumonia,while the four indexes were negatively correlated with CT pneumonia quantification at the peak time(r=-0.26 to-0.49,P＜0.001). CONCLUSIONS:URT lymphoid tissue hyperplasia assessed by MRI may be a protective factor against COVID-19 pneumonia.

Background: The value and necessity of pelvic computed tomography (CT) examination in gastric cancer (GC) staging is unknown and the recommendations are unclear in guidelines. The objective of this study was to evaluate the value and necessity of pelvic CT in routine GC staging.Methods: We reviewed the medical records of GC patients proved by endoscopic biopsy who received abdominopelvic CT examination before treatments at our institution from January 2013 through July 2017. The pathology findings seen in the pelvis were classified into two categories as metastatic disease or not. These findings were further categorized as isolated pelvis metastasis or not, and isolated pelvis metastasis was defined as the presence of pelvis metastasis without any other sites of metastasis on CT scan.Results: A total of 227 GC patients received abdominopelvic CT examinations at our institution. Of the patients, 22.0% (n=50) had findings in the pelvis, and the most common was ascites (8.8%, n=20). The metastatic diseases in pelvis were found in 2.2% (n=5) of all patients, including peritoneal thickening with nodules, left adnexal solid masses, bladder wall mass, bone lesions, and lymphatic spread. The isolated pelvis metastasis was found in 1.3% (n=3) of patients.Conclusions: Our results indicated that CT of the pelvis has a negligible yield in GC staging. In consideration of health care cost, radiation dose and radiologist fatigue, the pelvic CT performed as a routine staging tool for GC is unnecessary and not a wise choice in our setting.

Objective: To investigate whether the mindful exercise was more beneficial than non-mindful exercise for people with schizophrenia. Methods: PubMed, Embase, Cochrane Library, and PsycINFO were searched from their onset to April 2017. Randomized controlled trials of schizophrenia were selected. Mindful exercises were yoga, tai chi or qigong. Non-mindful exercises included any type of purely physical exercise. Risk of bias was assessed using criteria in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seven studies were identified. There were significant differences in favour of mindful exercise in psychiatric symptoms (total PANSS, 2 RCT, n = 101, MD -8.94, low-quality evidence) and "working memory" (1 RCT, n = 194, MD 0.39, low-quality). For outcomes of "attention" and social functioning, there was no clear difference. Four studies reported no adverse events. Conclusions: Mindful exercise was more beneficial over non-mindful exercise on some outcomes of psychiatric symptoms and cognitive performance for schizophrenia.

Bone mechanical properties encompass both geometric and material factors, while the effects of estrogen deficiency on the material and structural characteristics of bone at micro- to nanoscales are still obscure. We performed a series of combined methodological experiments, including nanoindentation assessment of intrinsic material properties, atomic force microscopy (AFM) characterization of trabecular (Tb) nanostructure, and Tb microarchitecture and 2D BMD. At 15 weeks after surgery, we found significantly less Tb bone mineral density (BMD) at organ (-27%) and at tissue level (-12%), Tb bone volume fraction (-29%), Tb thickness (-14%), and Tb number (-17%) in ovariectomy (OVX) rats than in sham operated (SHAM) rats, while the structure model index (+91%) and Tb separation (+19%) became significantly greater. AFM images showed lower roughness Tb surfaces with loosely packed large nodular structures and less compacted interfibrillar space in OVX than in SHAM. However, no statistically significant changes were in the Tb intrinsic material properties-nanoindentation hardness, elastic modulus, and plastic deformation-nanoindentation depths, and residual areas. Therefore, estrogen deprivation results in a dramatic deterioration in Tb micro/nanoarchitectures, 3D volumetric BMD at both organ and tissue levels, and 2D BMD, but not in the nanomechanical properties of the trabeculae per se.

BACKGROUND AND OBJECTIVE:Serum leptin measures are associated with radiographic knee osteoarthritis, but no studies have examined leptin levels with respect to different measures of knee joint damage from MRI. METHODS:Participants in the Michigan Study of Women's Health Across the Nation underwent bilateral knee MRIs at follow-up visit 11 for assessment of cartilage defects, bone marrow lesions, osteophytes, meniscal tears, synovitis and joint effusion. Serum leptin measures were available from baseline, follow-up visits 1 and 3-7. RESULTS:Baseline serum leptin levels were associated with greater odds of having more severe knee joint damage at follow-up visit 11 after adjustment for age, smoking status, menopause status and body mass index residuals. The greatest effect was observed for osteophytes; a 5 ng/ml increase in baseline leptin was associated with 24% higher odds of having larger osteophytes (95% CI 1.17 to 1.32). Correlations with baseline serum leptin were greatest for MRI-assessed osteophytes (r=0.41), followed by effusion (r=0.32), synovitis (r=0.30), cartilage defects (r=0.28), bone marrow lesions (r=0.24) and meniscal abnormalities (r=0.21). CONCLUSIONS:Leptin levels 10 years prior to MRI assessment were associated with the presence of cartilage defects, bone marrow lesions, osteophytes, meniscal tears, synovitis and effusion among a population of middle-aged women. Understanding the role that leptin plays in the joint degradation process is critical for development of more targeted interventions for osteoarthritis.

Objective To investigate the effect of glucocorticoid on bone mass in mature rats using dual X-ray absorptiometry (DXA).Methods Twenty-one 44-week female Sprague-Dawley rats were randomized into sham operation group (SHAM), ovariectomy group ( OVX) , and prednisolone group ( PRED) .Rats in PRED were injected with methylprednisolone at the dose of 2.5mg· kg-1· d-1.Bone mineral density (BMD), bone mineral content (BMC), and bone area (AREA) of the whole skeleton were measured using DXA (QDR-4500A, Hologic) every 4 weeks in vivo.At the 12th week after the operation, all the rats were executed.And then BMD, BMC, and AREA of the lumbar vertebrae, the femur, and the tibia were mesasured.The compression test was performed to test the maximum loading and elastic modulus of the L2 vertebrae.Results The body weight in OVX group increased significantly compared with that in SHAM group from the 8th week after the operation (the 8th week, P<0.05; the 12th week, P<0.01).The body weight in PRED group was significantly lower than that in SHAM group from the 4th week after the&nbsp;operation (P<0.05).BMC of the whole body in OVX group was significantly higher than that in SHAM group at the 12th week after the operation (P<0.05), and the results in OVX group at the 8th and the 12th week were significantly higher than those in PRED group (P<0.05).BMD of L5 and L6 and the BMC of L6 in OVX at the 12th week after the operation was significantly lower than that in SHAM or PRED group ( P<0.05 ) .No significant difference of BMD, BMC, and bone area of the lumbar vertebrae ( L4, L5, and L6) between PRED group and SHAM group was observed in vitro.Compared with that in SHAM group, a significant lower BMD of the femur ( -7.42%) , the distal femur ( -10.85%) , the proximal femur ( -6.92%) , and the proximal tibia (-11.40%) in OVX group at the 12 th week after the operation was observed in vitro.And a significantly lower BMC of the femur, the distal femur, and the proximal tibia was also observed (P<0.05).At the 12th week after the operation, no significant difference of BMD, BMC, and bone area of the whole femur and all regions of interest of the femur, and BMD of whole tibia and all regions of interest of the tibia was observed between SHAM and PRED group.Compared with that in SHAM group, a significant increase of the bone mass of the distal tibia in OVX group and PRED group was observed.And the maximum loading and elastic modulus in OVX group were significantly lower than those in SHAM group, and the maximum loading in PRED group also decreased significantly.Conclusion After the injection of methylprednisolone in mature rats, no significant change in cortical and cancellous bone mass is observed.It is difficult to detect the bone mass loss using DXA.The changes of biomechanical properties indicate that glucocorticoid induces the change of bone mass, thus resulting in the decrease of biomechanical properties and the occurrence of fractures.

Adolescent idiopathic scoliosis (AIS) is a complex three dimensional spinal deformity which occurs mostly in prepubertal and pubertal girls. Although bracing and surgery have been the mainstays of treatment for AIS, because of the complications and poor compliance, many patients with this disorder continue to experience significant residual symptoms. The etiology and pathogenesis of AIS is unclear, but recent studies show the association between osteopenia and AIS and imply that osteopenia play a causative role in the development of AIS. Anti-osteoporosis treatment can improve bone strength, prevent osteoporosis and rebalance the OPG–RANK–RANKL system, which may help to prevent curve progression in AIS. This report proposes that anti-osteoporosis treatment may be an effective treatment for AIS.

Bone microdamage can be repaired through bone remodeling induced by loading. In this study, a loading device was developed for improved efficiency and the self-repair process of bone microdamage was studied in ovariectomized rats. First, four-point bending fixtures capable of holding two live rats simultaneously were designed. Rats were loaded and subjected to a sinusoidal wave for 10,000 cycles. They were then divided into four groups to evaluate time points from 1 to 4 weeks in the microdamage repair process. The loaded right ulna was used for microdamage parameter analysis, and the loaded right radius was tested for mechanical properties. In all groups, microdamage consisted primarily of microcracks, which were observed in bone surrounding the force-bearing point. The values of the microdamage parameters were significantly lower at 3 weeks than at 2 weeks. However, none of the differences in mechanical properties between any four groups were statistically significant. This study shows that the improved application of loading in the form of bending for double-rat simultaneous administration was practical and efficient. These results suggest that microdamage was repaired between 2 weeks to 3 weeks after fatigue damage and microdamage is a more sensitive index of bone quality than mechanical properties.

BACKGROUNDThe prevalence of knee osteoarthritis is traditionally based on radiographic findings, but magnetic resonance imaging is now being used to provide better visualization of bone, cartilage, and soft tissues as well as the patellar compartment. The goal of this study was to estimate the prevalences of knee features defined on magnetic resonance imaging in a population and to relate these abnormalities to knee osteoarthritis severity scores based on radiographic findings, physical functioning, and reported knee pain in middle-aged women.METHODSMagnetic resonance images of the knee were evaluated for the location and severity of cartilage defects, bone marrow lesions, osteophytes, subchondral cysts, meniscal and/or ligamentous tears, effusion, and synovitis among 363 middle-aged women (724 knees) from the Michigan Study of Women's Health Across the Nation. These findings were related to Kellgren-Lawrence osteoarthritis severity scores from radiographs, self-reported knee pain, self-reported knee injury, perception of physical functioning, and physical performance measures to assess mobility. Radiographs, physical performance assessment, and interviews were undertaken at the 1996 study baseline and again (with the addition of magnetic resonance imaging assessment) at the follow-up visit during 2007 to 2008.RESULTSThe prevalence of moderate-to-severe knee osteoarthritis changed from 3.7% at the baseline assessment to 26.7% at the follow-up visit eleven years later. Full-thickness cartilage defects of the medial, lateral, and patellofemoral compartments were present in 14.5% (105 knees), 4.6% (thirty-three knees), and 26.2% (190 knees), respectively. Synovitis was identified in 24.7% (179) of the knees, and joint effusions were observed in 70% (507 knees); 21.7% (157) of the knees had complex or macerated meniscal tears. Large osteophytes, marked synovitis, macerated meniscal tears, and full-thickness tibial cartilage defects were associated with increased odds of knee pain and with 30% to 40% slower walking and stair-climbing times.CONCLUSIONSMiddle-aged women have a high prevalence of moderate-to-severe knee osteoarthritis corroborated by strong associations with cartilage defects, complex and macerated meniscal tears, osteophytes and synovitis, knee pain, and lower mobility levels.

Background: The relationship between the levels of gonadotropic hormones and bone metabolism-related cytokines in Chinese women is unclear. We investigated the relationship between FSH and LH and OPG, leptin, TGF-beta 1, and TGF-beta 2 in Chinese women.Methods: A cross-sectional study of 694 Chinese women, aged 20 to 82 y was conducted. Levels of serum FSH, LH, OPG, leptin. TGF-beta 1, and TGF-beta 2 were determined.Results: In premenopausal females, serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels seemly showed no correlation with the cytokine levels. In perimenopausal females, serum FSH and LH levels showed significant positive correlation with osteoprotegerin (OPG) and transforming growth factor-beta 2 (TGF-beta 2) levels (r = 0.286 to 0.405, all P = 0.000), whereas they showed negative correlation with TGF-beta 1 levels (r = 0.413 and 0.354, all P = 0.000). In postmenopausal females. FSH and LH levels showed positive correlation with OPG levels (r = 0.247 and 0.241, all P = 0.000), negative correlation with leptin and TGF-beta 1 levels (r = -0.234 to -0.319, all P = 0.000), and no correlation with TGF-beta 2 levels. Multiple linear regression stepwise analysis revealed the following results. In premenopausal females, 2.0% and 1.5% of the changes in LH could be explained by OPG and leptin, respectively, while 1.9% of the changes in OPG could be explained by LH. In perimenopausal females, the determinants of OPG and TGF-beta 1 on FSH were 10.9% and 17.0%, respectively, and the determinants of OPG, TGF-beta 1 and TGF-beta 2 on LH were 4.5%, 4.9% and 16.4%, respectively. The determinants of FSH and LH on OPG were 14.5% and 2.5%, respectively. The determinant of FSH on TGF-beta 1 was 4.5%, while the determinant of LH on TGF-beta 2 was 16.4%. In postmenopausal females, the determinants of leptin and OPG on FSH were 10.2% and 2.8%, respectively, and the determinants of OPG and TGF-beta 1 on LH were 5.8% and 2.3%, respectively. The determinant of FSH on OPG, leptin and TGF-beta 1 were 6.1%, 3.4% and 9.2%.Conclusions: These results indicate that age-related gonadotropic hormone levels are associated with changes in OPG, TGF-beta 1, TGF-beta 2 and leptin, and change with menopausal status. (C) 2010 Elsevier B.V. All rights reserved.

Conventional radiography, ultrasound, CT, MRI, and nuclear imaging are the current imaging modalities used for clinical evaluation of arthritis which is highly prevalent and a leading cause of disability. Some of these types of imaging are also used for monitoring disease progression and treatment response of arthritis. However, their disadvantages limit their utilities, such as ionizing radiation for radiography, CT, and nuclear imaging; suboptimal tissue contrast resolution for radiography, CT, ultrasound, and nuclear imaging; high cost for CT and MRI and nuclear imaging; and long data-acquisition time with ensuing patient discomfort for MRI. Recently, there have been considerable advances in nonionizing noninvasive optical imaging which has demonstrated promise for early diagnosis, monitoring therapeutic interventions and disease progression of arthritis. Optical based molecular imaging modalities such as fluorescence imaging have shown high sensitivity in detection of optical contrast agents and can aid early diagnosis and ongoing evaluation of chronic inflammatory arthritis. Optical transillumination imaging or diffuse optical tomography may differentiate normal joint clear synovial fluid from turbid and pink medium early in the inflammatory process. Fourier transform infrared spectroscopy has been used to evaluate fluid composition from joints affected by arthritis. Hemodynamic changes such as angiogenesis, hypervascularization, and hypoxia in arthritic articular tissue can potentially be observed by diffuse optical tomography and photoacoustic tomography. Optical measurements could also facilitate quantification of hemodynamic properties such as blood volume and oxygenation levels at early stages of inflammatory arthritis. Optical imaging provides methodologies which should contribute to detection of early changes and monitoring of progression in pathological characteristics of arthritis, with relatively simple instrumentation.

OBJECTIVE:To assess the role of obesity and metabolic dysfunctionality with knee osteoarthritis (OA), knee joint pain, and physical functioning performance, adjusted for joint space width (JSW) asymmetry. METHODS:Knee OA was defined as a Kellgren/Lawrence score > or =2 on weight-bearing radiographs. Obesity was defined as a body mass index > or =30 kg/m2. Cardiometabolic clustering classification was based on having > or =2 of the following factors: low levels of high-density lipoprotein cholesterol; elevated levels of low-density lipoprotein cholesterol, triglycerides, blood pressure, C-reactive protein, waist:hip ratio, or glucose; or diabetes mellitus. The difference between lateral and medial knee JSW was used to determine joint space asymmetry. RESULTS:In a sample of women (n = 482, mean age 47 years), prevalences of knee OA and persistent knee pain were 11% and 30%, respectively. The knee OA prevalence in nonobese women without cardiometabolic clustering was 4.7%, compared with 12.8% in obese women without cardiometabolic clustering and 23.2% in obese women with cardiometabolic clustering. Nonobese women without cardiometabolic clustering were less likely to perceive themselves as limited compared with women in all other obesity/cardiometabolic groups (P < 0.05). Similar associations were seen with knee pain and physical functioning measures. The inclusion of a joint space asymmetry measure was associated with knee OA but not with knee pain or physical functioning. CONCLUSION:Knee OA was twice as frequent in obese women with cardiometabolic clustering compared with those without, even when considering age and joint asymmetry. Obesity/cardiometabolic clustering was also associated with persistent knee pain and impaired physical functioning.

In the presence of joint space narrowing, it is important to differentiate inflammatory from degenerative conditions. Joint inflammation is characterized by bone erosions, osteopenia, soft-tissue swelling, and uniform joint space loss. Inflammation of a single joint should raise concern for infection. Multiple joint inflammation in a proximal distribution in the hands or feet without bone proliferation suggests rheumatoid arthritis. Multiple joint inflammation in a distal distribution in the hands or feet with bone proliferation suggests a seronegative spondyloarthropathy, such as psoriatic arthritis, reactive arthritis, or ankylosing spondylitis.

In the presence of joint space narrowing, it is important to differentiate inflammatory from degenerative conditions. The presence of osteophytes, bone sclerosis, and subchondral cysts and the absence of inflammatory features such as erosions suggest osteoarthritis. Typical osteoarthritis involves specific joints at a particular patient age. When osteoarthritis involves an atypical joint, occurs at an early age, or has an unusual radiographic appearance, then other causes for cartilage destruction should be considered, such as trauma, crystal deposition, neuropathic joint, and hemophilia. There are several types of arthritis, such as juvenile chronic arthritis and gouty arthritis, that may have a variable appearance compared with that of other common inflammatory arthritides.

The center of rotation is a physical location in the microCT scanner, defined by the axis of rotation of the sample stage. This physical location is always well defined during calibration of the instrument and fitted by an appropriate algorithm. However, in real images of limited contrast and with X-ray photon noise, this algorithm exhibits poorer precision and the optimum center of rotation cannot be always acquired. Thus, adjustment by operator is necessary to determine whether the center of rotation was correct, in order that the structural information of the sample can be correctly interpreted. In this paper, the effect of center of rotation on the assessment of densitometric and structural properties of trabecular bone was firstly evaluated. Twenty female Sprague-Dawley rats of 7-month-old were randomly assigned to ovariectomized (OVX) and SHAM-operated (SHAM) groups. The left tibiae were harvested at 3 weeks postoperatively. High resolution microCT was used to identify the densitometric and microstructural properties of trabeculae in the proximal ends of tibia. After CT scanning, the best artificial center of rotation for each scan was obtained. Bone parameters analyses were performed on the centers at different places away from the best artificial center of +/-0.2, +/-0.5, +/-1.0, +/-1.5, and +/-2.0 pixels, respectively. The general linear model (GLM) repeated measures procedure was used to investigate the difference in the parameters between the two groups (OVX vs. SHAM) and the possible effects of center displacements. A significant difference between OVX and SHAM groups was found in all parameters (p < 0.05) except Tb.Th, DA, and BS/BV. TBMD, DA, BS/BV, and Conn.D were decreased while BV/TV and Tb.Th were increased with the center deflection. Variations of these parameters were acceptable when the displacements were limited within +/-1.5 pixels for tBMD, BV/TV, DA, and Conn.D, and +/-1.0 pixels for Tb.Th and BS/BV. These changes were similar in both OVX and SHAM groups. The changing curves of bone parameters vs. centers could be well fitted by quadric regression models, by which the real center could be acquired, and thus the precision of microCT analysis would be improved. There were some inevitable differences between the best artificial and real centers.

Advanced imaging techniques, which are noninvasive and nondestructive, can provide structural information about bone beyond simple bone densitometry. As the mechanical competence of trabecular bone is a function of its apparent density and 3D distribution, assessment of 3D trabecular structural characteristics may improve our ability to understand the pathophysiology of osteoporosis, to test the efficacy of pharmaceutical intervention, and to estimate bone biomechanical properties. We studied ovariectomy-induced osteopenia in rats with various treatments. Micro-CT is also useful for studying osteoporosis in mice and phenotypes of mice with gene manipulation. Micro-CT can quantify osteogenesis in mouse Ilizarov leg-lengthening procedures, osteoconduction in rat cranial defect models, and structural changes in arthritic rabbits, rats, and mice. Micro-CT can reproducibly quantify 3D microarchitecture of new bone formation inside the pores of titanium prosthesis implants is rabbits. In clinical studies, we evaluated longitudinal changes in iliac crests in premenopausal and postmenopausal women. Paired bone biopsies from postmenopausal women with osteoporotic fracture shows that 3D trabecular microstructure deteriorates in the iliac crest of postmenopausal osteoporotic women without active treatment. Three-dimensional microstructural parameters can predict fracture. Treatment of PTH in postmenopausal women with osteoporosis significantly improved trabecular morphology with a shift toward a more plate-like structure, increased trabecular connectivity, and increased cortical thickness. Paired bone biopsy specimens from the iliac crest in postmenopausal women with osteoporosis before and after beginning estrogen replacement therapy demonstrated in post-treatment biopsies a significant change in the ratio of plates to rods. High-resolution MR and mu MR have received considerable attention both as research tools and potential clinical tools for assessment of osteoporosis. It has been used in studying human specimens or animal models of osteoporosis with various treatment strategies. MR microscopy has been shown to capable of differentiating trabecular structure in the distal radius and the calcaneus in postmenopausal women with or without osteoporotic fracture. It has been used in studying human specimens or animals models of osteoporosis with various treatment strategies. A high field MR study show that ovariectomy in ewes induces deterioration of trabecular microstructure and biomechanical property of the femoral neck. These changes are prevented by calcitonin in a dose-dependent manner. Univariate analysis and multivariate stepwise regression analysis indicate that microarchitecture of trabecular bone contributes significantly to its biomechanical characteristics, independent of BMD measured in the femoral neck. Combination of trabecular microstructure with BMD improves prediction of bone quality.

Strontium ranelate is a new anti-osteoporotic treatment. On bone biopsies collected from humans receiving long-term treatment over 5 yr, it has been shown that strontium ranelate has good bone safety and better results than placebo on 3D microarchitecture. Hence, these effects may explain the decreased fracture rate. Introduction: Strontium ranelate's mode of action involving dissociation of bone formation and resorption was shown in preclinical studies and could explain its antifracture efficacy in humans. Materials and Methods: One hundred forty-one transiliac bone biopsies were obtained from 133 postmenopausal osteoporotic women: 49 biopsies after 1-5 yr of 2 g/d strontium ranelate and 92 biopsies at baseline or after 1-5 yr of placebo. Results and Conclusions: Histomorphometry provided a 2D demonstration of the bone safety of strontium ranelate, with significantly higher mineral apposition rate (MAR) in cancellous bone (+9% versus control, p = 0.019) and borderline higher in cortical bone (+10%, p = 0.056). Osteoblast surfaces were significantly higher (+38% versus control, p = 0.047). 3D analysis of 3-yr biopsies with treatment (20 biopsies) and placebo (21 biopsies) using mu CT showed significant changes in microarchitecture with, in the strontium ranelate group, higher cortical thickness (+18%, p = 0.008) and trabecular number (+14%, p = 0.05), and lower structure model index (-22%, p = 0.01) and trabecular separation (-16%, p = 0.04), with no change in cortical porosity. The changes in 3D microarchitecture may enhance bone biomechanical competence and explain the decreased fracture rate with strontium ranelate.