Lower Extremity Skeletal Morphology Measured by Standing Biplanar Radiographs Differs by Race and Sex

Abstract Background This study used bi-planar low-dose X-ray images to identify differences in lower extremity skeletal morphology by race and sex that might contribute to observed disparities in the occurrence of musculoskeletal disorders. Methods We enrolled a multiracial cohort of young adults (n = 172) that included Asian women (n = 29) and men (n = 31), Black women (n = 28) and men (n = 27), and White women (n = 28) and men (n = 29). Low-dose anterior-posterior and lateral lower extremity X-ray images were simultaneously acquired in weight-bearing, standing position with EOS™ imaging system. Results While pelvic morphology did not differ significantly by race or sex, we identified differences in hip and lower extremity morphology measures between Black, White, and Asian men and women. These differences remained significant after adjusting for height and weight, factors known to influence skeletal morphology. Conclusion Further work is needed to determine whether these differences in skeletal morphology contribute to sex and racial disparities in musculoskeletal disorder prevalence, risk, and outcomes.