J Med Assoc Thai 2015; 98 (1):39

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Original ArticleOpen Access
Correlation of Proximal Femoral Bone Geometry from Plain Radiographs and Dual Energy X-Ray Absorptiometry in Elderly Patients
Vaseenon T Mail, Chaimuang C , Phanphaisarn A , Namwongprom S , Luevitoonvechkij S , Rojanasthien S

Background: Fracture prevention in osteoporotic patients is the primary treatment goal in assessing bone mineral density, identification of fracture risk, and determination of who should be treated. The literature shows that parameters of proximal femoral bone geometry such as hip axis length, femoral neck shaft angle (FNA), femoral neck width (FNW) and femoral neck cortical thickness (FNCT) can predict the risk of hip fracture. Those parameters are presented automatically with dual energy X-ray absorptiometry (DXA) scans, which are available in well-equipped hospitals.

Objective: To determine the correlation between proximal femoral bone geometry and the parameters from DXA scans and those from plain radiographs.

Material and Method: Forty-eight patients with no previous hip fractures or history of secondary osteoporosis underwent both a DXA scan of the hip area and a plain hip radiograph done in the same position, 25 degrees internal rotation. Bone geometries from both groups were measured to determine the correlation using Pearson correlation coefficient.

Results: Correlation between the parameters HAL, FNA, FNW and FNCT from the DXA scans and from the measurement of the plain radiograph was significant (p<0.01) and the level of correlation was moderate to high. The FNCT had least mean difference (0.04). In addition, the parameter FNCT, less than 0.29 mm in both DXA scans and plain radiographs, showed a significant correlation with osteoporosis (T-score <-2.5).

Conclusion: The bone geometry parameters from either DXA scans or plain radiographs may be used to predict osteoporotic hip fracture with a moderate to high correlation. Plain radiographs are very helpful when DXA scan results are not available. The FNCT parameter has a strong correlation with osteoporosis.

Keywords: Bone geometry, Hip fracture, DXA, Plain X-ray, Osteoporosis, BMD


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