Analysis of trabecular proximal femur bone in diagnosing osteoporosis using digital x-ray: A comparison with DXA

Osteoporosis is a low bone mass oriented disease which can be diagnosed by measuring bone mineral density (BMD). Dual energy x-ray absorptiometry (DXA) method is considered as `gold´ standard for measuring BMD. WHO has defined a diagnostic criterion for the disease, based on DXA-BMD measurement at proximal femur and spine. In India, it is highly prevalent in post menopausal women and elderly subjects of both the sexes. The diseases related to hip and spine often equated with significant amount of mortality and morbidity. Fracture prevention, before its happening is the need of the hour. The DXA measures only areal BMD (g. cm-2), whereas it always bypasses the geometry and micro architecture of the bone. The aim of the proposed study was to test the potentiality of energy of the trabecular bone of the proximal femur that has been measured using Dual-tree complex wavelet transform (DT-CWT) in the evaluation of post-menopausal osteoporosis, when comparing with DXA as `gold´ standard. DXA-BMD of the right proximal femur of 50 (n=50, mean ± SD age = 50.1 ± 13.7 years) south Indian women aged above 25 years was measured. WHO criteria was used in all women; a standard digital x-ray of the right proximal femur was obtained and DT-CWT was carried out in two different approaches.