Evaluation of osteoporosis using radiographic hip geometry, compared with dual energy X-ray absorptiometry (DXA) as the standard

Osteoporotic hip fracture is associated with high mortality and morbidity and often results in a loss of mobility and independence. Osteoporosis is diagnosed by measuring bone mineral density (BMD, g cm^-2), a measure of the amount of mineral in a bone. Although BMD continues to serve well it does not fully account for bone strength and only partially accounts for the risk of hip fracture. The shape and structure of the proximal femur also helps to determine how forces act in the hip in a fall and their measurement can aid the prediction of hip fracture. In this study, the geometrical variables of the right proximal femur in a total number of fifty Indian women were measured from digital x-ray images, and these results were compared with BMD values of the proximal femur measured by Dual energy x-ray absorptiometry (DXA) for same set of women, as a standard. Results obtained by this proposed approach explored how they were related with BMD and anthropometric factors such as body-height, and body-weight. In this study, it was found that 34% and 20% of the study Indian women were found to have osteoporosis and osteopenia respectively. The mean values of thickness of the medial shaft cortex (SC) as well as lesser trochanter thickness of the medial cortex (NC) and width of the acetabular bone (AW) were lesser in the osteoporotic Indian women than in normal Indian women. These values were found to be decreased by -21%, -11%, and -18% respectively, when comparing to normal Indian women. Simple radiograph hip geometry measurements are useful in the evaluation of osteoporosis.