DXA remains the clinical mainstay of osteoporosis diagnosis, based on measurement of areal bone mineral density (aBMD) at the hip and lumbar spine. Decision making is based on T-score, which is the number of standard deviations that a patient’s aBMD measurements are relative to mean values from a young healthy adult population [1].

IBEX BH is a CE-marked commercial software application that can estimate aBMD at the wrist from radiographs. This enables it to opportunistically identify those at potential risk of fragility fracture whilst undergoing wrist imaging for other clinical reasons. The software has been validated in the OFFER1 trial, where software outputs were compared with DXA results at the wrist, hip and spine in research participants over 50 years of age [2].

This study aims to validate IBEX Bone Health (IBEX BH) measures of areal Bone Mineral Density (aBMD) from standard wrist radiographs against reference standard Dual-energy X-ray Absorptiometry (DXA) on a cohort 20-30 years of age. It is important to evidence the performance of IBEX BH in this key age group, which typically provides reference data for DXA analysis, and to also explore the potential use case of IBEX BH in medical conditions leading to poor bone health in young adult populations.