Dual-Energy X-Ray Absorptiometry: Beyond Bone Mineral Density Determination

Significant improvements in dual-energy X-ray absorptiometry (DXA) concerning quality, image resolution and image acquisition time have allowed the development of various functions. DXA can evaluate bone quality by indirect analysis of micro- and macro-architecture of the bone, which and improve the prediction of fracture risk. DXA can also detect existing fractures, such as vertebral fractures or atypical femur fractures, without additional radiologic imaging and radiation exposure. Moreover, it can assess the metabolic status by the measurement of body composition parameters like muscle mass and visceral fat. Although more studies are required to validate and clinically use these parameters, it is clear that DXA is not just for bone mineral densitometry.

Hip Structure Associated With Hip Fracture in Women: Data from the Geelong Osteoporosis Study (Gos) Data Analysis-Geelong, Australia

Aging leads to changes in bones to be highly fragile causing fractures. In this research, changes in the dimensions of the hip structure can be measured by using a computer program called ‘Hip Structural Analysis (HSA)’. The objective of this study is to estimate the association between hip geometries in Femoral Neck (FN) and the risk of hip fracture in older women. A case control study was performed to explore the objective respectively using the data of participants from population cohort and fracture cohort of the Geelong Osteoporosis Cohort Geelong, Southern Victoria, Australia. Simple and multiple logistic regressions were performed.Of total of 598, comparing Fracture group (44 subjects) and nonfracture group (454 subjects) aged over 63 years, the odds of hip fracture increased by approximately 2 fold for each 1 SD increase in width (OR=1.70(1.18-2.45,p 0.005), endocortical diameter (OR=1.80 (1,23-2.62, p=0.002), and buckling ratio (OR=1.85(1.32- 2.61, p <0.0001) and for each 1 SD decrease in BMD (OR=1.98(1.21-3.23,p.0.006) and average cortical thickness (OR=2.02(1.23-3.34), p.0.006) controlling for age, height, weight and menopausal status. Findings suggest that not only is BMD associated with hip fractures, but also other hip geometry dimensions, including WID, ENDO, AVCO and AVBR, independent of age, height, weight and physical activity.These results provide additional insights that the geometries of FN is associated with fracture neck of femur in older women and strongly suggest its potential value, not only BMD, as clinical predictors for assessing the risk of hip fracture in older women. In addition to this, utilization of some combined parameters of bone geometries in FN might be a more effective method in screening than case findings to reduce the burden of hip fracture in the future. Further statistical methods is needed to analyze the combined hip structure to predict hip fracture.