Using shoulder X-rays to spot bone loss in the weak arm after stroke
Compares arm bone thickness on shoulder X-rays in adults after a stroke.
Plain-language title generated from the registry record
Registry title: Radiographic Cortical Thickness of the Humerus in Detecting Post-Stroke Regional Bone Loss
Key facts
- Where
- Istanbul, TürkiyeSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults who had one stroke on one side at least 6 months ago and now have weakness on one side of the body. Their shoulder X-rays and bone density scans must already be available.
- Age
- 18 years and older
- Sex
- All sexes
- Disease stage
- A single stroke on one side of the brain at least 6 months ago, with weakness on one side of the body (hemiparesis).
- Earlier treatment
- No history of corticosteroid use. No surgery on either shoulder.
- Biomarker or test result
- A standard front-view (AP) shoulder X-ray taken within 6 months after the stroke, and a bone density scan (DXA) must both be available.
Main reasons for not taking part
- Surgery on either shoulder
- Past fracture of the upper part of the upper arm bone (proximal humerus)
- Other bone diseases such as primary hyperparathyroidism or osteomalacia
- History of cancer
- A second stroke
Read by machine on 12 November 2026.
Where in Türkiye
- Istanbul Physical Medicine Rehabilitation Training and Research HospitalIstanbul, TürkiyeContact: Ismet Alkim Ozkan MDTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Istanbul Physical Medicine Rehabilitation Training and Research Hospital
- Trial code
- NCT07651306
- Record updated
- 16 June 2026
- Original description
Post-stroke immobilization and reduced weight-bearing frequently lead to significant regional bone mineral density loss and asymmetry, particularly in the paretic upper extremity, which increases fracture risks. While Dual-Energy X-ray Absorptiometry (DXA) is the gold standard for evaluating systemic bone loss, it primarily focuses on axial or lower extremity sites and lacks universal accessibility. Since routine shoulder radiographs offer an opportunistic screening tool to evaluate regional bone quality without additional radiation , this study aims to compare proximal humerus cortical bone thickness between the paretic and non-paretic sides in stroke patients and assess its correlation with systemic DXA values to determine its clinical utility.Read full original descriptionShow less
Radiographic Cortical Thickness of the Humerus in Detecting Post-Stroke Regional Bone Loss
Post-stroke immobilization and reduced weight-bearing frequently lead to significant regional bone mineral density loss and asymmetry, particularly in the paretic upper extremity, which increases fracture risks. While Dual-Energy X-ray Absorptiometry (DXA) is the gold standard for evaluating systemic bone loss, it primarily focuses on axial or lower extremity sites and lacks universal accessibility. Since routine shoulder radiographs offer an opportunistic screening tool to evaluate regional bone quality without additional radiation , this study aims to compare proximal humerus cortical bone thickness between the paretic and non-paretic sides in stroke patients and assess its correlation with systemic DXA values to determine its clinical utility.
This cross-sectional, observational study involves a retrospective data analysis of patients aged 18 and older who experienced a single unilateral stroke at least 6 months prior and present with clinical hemiparesis. Eligible participants must have concurrent standard anteroposterior shoulder radiographs and DXA measurements available from their routine clinical follow-ups. Patient demographic data, stroke characteristics, Brunnstrom stages, and systemic DXA measurements (femoral neck and lumbar spine T-scores and bone mineral density values) are systematically recorded for analysis.
Cortical bone thickness measurements are performed using ImageJ software on standard radiographs at points 10 cm and 12 cm distal to the highest point of the humerus. To ensure reliability, measurements for both the paretic and non-paretic sides are conducted independently by two researchers who are completely blinded to the DXA results. Statistical analyses, including paired t-tests or Wilcoxon tests and Pearson or Spearman correlations, will be used to compare the sides and evaluate the relationship between radiographic cortical thickness and systemic bone density.
Inclusion: Patients aged 18 years and older; A documented history of a single unilateral stroke that occurred at least 6 months prior to evaluation; Presence of clinical hemiparesis; Availability of concurrent standard anteroposterior (AP) shoulder radiographs taken within 6 months post-stroke alongside systemic DXA measurements.
Exclusion: History of surgical intervention in either shoulder. History of a proximal humerus fracture; Co-existing metabolic bone diseases, such as primary hyperparathyroidism or osteomalacia; History of malignancy; Documented history of corticosteroid use; History of a secondary stroke; Imaging artifacts that compromise the accuracy of DXA measurements.