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Diagnostic Coincidence of Radiologic Measurement Methods of the Proximal Femur Anterior-posterior Projection for Assessment of Osteoporosis

근위대퇴부 정면 영상을 이용한 골다공증 평가 시 방사선적 계측의 진단일치도

  • Received : 2012.04.10
  • Accepted : 2012.06.07
  • Published : 2012.06.28

Abstract

The purpose of this study was to determine whether there are relationships between radiologic parameters for osteoporosis by the proximal femur radiograhps and bone mineral density, as assessed by Dual Energy X-ray Absorptiometry(DEXA). Proximal femur anterior-posterior projection were taken from 112 individuals who undergoing DEXA. Radiographic parameters including canal-to-calcar ratio(CCR) and cortical thickness indices(CTI) were measured and compared with bone mineral density($g/cm^2$), T-score. The intramedullary femoral canal width(FW) and calcar width(CW) at osteoporosis group was significantly larger than that of control group. The CCR were correlated negatively with bone mineral density($g/cm^2$)(r=-0.340, p<0.01), and the CTI were correlated positively(r=0.624). The diagnostic accuracy of CCR for osteoporosis was 63.4%, and kappa value was 0.271. And the accuracy of CTI was 67.0%, and kappa value was the level of fair agreement(${\kappa}$=0.258). The proximal femur with large CCR and small CTI had lower T-scores. When evaluating proximal femur anterior-posterior radiographs, those patients with the thinnest femur diaphyseal cortices should be referred for further osteoporosis investigation.

Keywords

Proximal Femur Anterior-posterior Projection;Canal-to-calcar Ratio;Cortical Thickness Indices;Osteoporosis

References

  1. H. F. Boehm and T. M. Link, "Bone imaging: traditional techniques and their interpretation," Curr Osteoporos Rep, Vol.2, No.2, pp.41-46, 2004. https://doi.org/10.1007/s11914-004-0002-6
  2. DO' Gradaigh, I Debiram, S Love, HK Richards, and JE Compston, "A prospective study of discordance in diagnosis of osteoporosis using spine and proximal femur bone densitometry," Osteoporos Int, Vol.14, No.1, pp.13-18, 2003. https://doi.org/10.1007/s00198-002-1311-1
  3. N. B. Watts, "Fundamentals and pitfalls of bone densitometry using dual-energy X-ray absorptiometry (DXA)," Osteoporos Int, Vol.15, pp.847-854, 2004. https://doi.org/10.1007/s00198-004-1681-7
  4. E. Lachmann, and M. Whelan, "The roentgen diagnosis of osteoporosis and its limitation," Radiology, Vol.26, pp.165-177, 1936. https://doi.org/10.1148/26.2.165
  5. M. Singh, A. R. Nagrath, and P. S. Maini, "Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis," J Bone Joint Surg Am, Vol.52, pp.457-467, 1970. https://doi.org/10.2106/00004623-197052030-00005
  6. L. D. Dorr, M. C. Faugere, A. M. Mackel, T. A. Gruen, B. Bognar, and H. H. Malluche, "Structural and cellular assessment of bone quality of proximal femur," Bone, Vol.14, No.3, pp.231-242, 1993. https://doi.org/10.1016/8756-3282(93)90146-2
  7. A. P. Sah, T. S. Thornhill, M. S. Leboff, and J. Glowacki, "Correlation of plain radiographic indices of the hip with quantitative bone mineral density," Osteoporosis Int, Vol.18, No.8, pp.1119-1126, 2007. https://doi.org/10.1007/s00198-007-0348-6
  8. T. Kawashima and H. K. Uhthoff, "Pattern of bone loss of the proximal femur: a radiologic, densitometric, and histomorphometric study," J Orthop Res, Vol.9, No.5, pp.634-640, 1991. https://doi.org/10.1002/jor.1100090503
  9. V. C. Koot, S. M. M. J. Kesselaer, G. J. Clevers, P. de Hooge, T. Weits, and C. van der Werken, "Evaluation of the Singh index for measuring osteoporosis," J Bone Joint Surg Br, Vol.78-B, pp.831-834, 1996. https://doi.org/10.1302/0301-620X.78B5.0780831
  10. H. Pogrund, W. M. Rigal, M. Makin, G. Robin, J. Menczel, and R. Steinberg, "Determination of osteoporosis in patients with fractured femoral neck using the Singh Index: a Jerusalem study," Clin Orthop Relat Res. Vol.156, pp.189-195, 1981.
  11. 한범희, 정홍량, 임청환 등, "DXA 측정기 종류에 따른 요추부와 대퇴경부 골밀도 값의 측정 오차 비교", 한국콘텐츠학회, 제10권, 제3호, pp.250-257, 2010.
  12. H. Y. Ho, J. W. Yi, D. S. Lim, "Reliability of the Radiologic Measurement Methods for Assessment of osteoporosis Using the Digital Radiograph," J Korean Hip Soc, Vol.23, No.2, pp.142-150, 2011. https://doi.org/10.5371/jkhs.2011.23.2.142
  13. Y. Yeung, K. Y. Chiu, W. P. Yau, "Assessment of the proximal femoral morphology using plain radiograph- Can it predict of the bone quality?," The Journal of Arthroplasty, Vol.21, No.4, pp.508-513, 2006. https://doi.org/10.1016/j.arth.2005.04.037
  14. F. E. Lindhardt, "Clinical experiences with computed radiography," Eur J Radiol, Vol.22, No.3, pp.175-185, 1996. https://doi.org/10.1016/0720-048X(96)89640-9
  15. T. Okamura, S. Tanaka, K. Koyama, "Clinical evaluation of digital radiography based on a large-area cesium iodide-amorphous silicon flat-panel detector compared with screen-film radiography for skeletal system and abdomen," Eyer Radiol, Vol.12, No.4, pp.1741-1747, 2002. https://doi.org/10.1007/s00330-001-1283-0