J Korean Hip Soc.  2011 Jun;23(2):142-150. 10.5371/jkhs.2011.23.2.142.

Reliability of the Radiologic Measurement Methods for Assessment of Osteoporosis Using the Digital Hip Radiograph

• Yun HH
• Yi JW
• Lim DS
• Park SC
• Oh SR

• KMID: 2190726
• DOI: http://doi.org/10.5371/jkhs.2011.23.2.142

Abstract

PURPOSE
We evaluated the usefulness of radiographic parameters for osteoporosis by analyzing the results of radiographic parameters determined by digital hip radiographs and bone mineral density T-scores, as assessed by Dual Energy X-ray Absorptiometry (DEXA).
MATERIALS AND METHODS
The authors reviewed 100 subjects in the hip fracture group and 50 in the non-fracture control group. Digital hip radiographs were assessed to determine the values of Singh index, Canal-to-Calcar Ratio, and Cortical Thickness Index (CTI). Bone mineral density was assessed by DEXA.
RESULTS
Intraclass Correlation Coefficient (ICC) results of the CTI were above 0.8 in the fracture group. Compared to the control group, the fracture group showed higher ICCs. Interobserver ICCs were especially lower in the control group. There were statistically significant correlations between CTI and DEXA (r=0.50~0.58, p<0.05). In the analysis of ROC curves, a mean threshold for CTI set a value of 0.54 (0.53~0.55), and mean sensitivity and specificity were 75.5% (69~79%) and 67.8% (65~78%), respectively.
CONCLUSION
CTI showed reasonable reliability and correlation with DEXA results. CTI was a useful radiographic parameter to alert the surgeon to recommend referral for osteoporosis evaluation in elderly hip fracture patients.

Keyword

Hip; Hip fracture; Osteoporosis; Radiographic parameter; Digital radiograph

MeSH Terms

Absorptiometry, Photon
Aged
Bone Density
Hip
Humans
Osteoporosis
Referral and Consultation
ROC Curve
Sensitivity and Specificity

Figure

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  Fig. 1 Measurement of calcar-to-canal ratio by FW/CW on anteroposterior radiograph of the hip.

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  Fig. 2 Cortical thickness index measurement on anteroposterior radiograph of the hip. Cortical thickness index is equal to femoral diaphysis with minus intramedullary width divided by diaphysis width.

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  Fig. 3 Receiver Operation Characteristic Curves of the cortical thickness index results.

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