Distribution of bone density and cortical thickness in the proximal femur and their association with hip fracture in postmenopausal women: a quantitative computed tomography study

• Published in: Osteoporosis international 2014, Vol.25 (1), p.251-263
• Main Authors: Yang, L., Udall, W. J. M., McCloskey, E. V., Eastell, R.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Aged; Aged, 80 and over; Bone density; Bone Density - physiology; Bone mineral density; Case-Control Studies; Endocrinology; Female; Femur - diagnostic imaging; Femur - pathology; Femur - physiopathology; Femur Head - diagnostic imaging; Femur Head - physiopathology; Fractures; Hip Fractures - diagnostic imaging; Hip Fractures - etiology; Hip Fractures - pathology; Hip Fractures - physiopathology; Hip joint; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - diagnostic imaging; Osteoporosis, Postmenopausal - pathology; Osteoporosis, Postmenopausal - physiopathology; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - pathology; Osteoporotic Fractures - physiopathology; Radiographic Image Interpretation, Computer-Assisted - methods; Rheumatology; Tomography; Tomography, X-Ray Computed - methods; Womens health
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-013-2401-y

Summary The quantitative computed tomography (QCT) scans in an individually matched case–control study of women with hip fracture were analysed. There were widespread deficits in the femoral volumetric bone mineral density (vBMD) and cortical thickness of cases, and cortical vBMD and thickness discriminated hip fracture independently of BMD by dual-energy X-ray absorptiometry (DXA). Introduction Acknowledging the limitations of QCT associated with partial volume effects, we used QCT in an individually matched case–control study of women with hip fracture to better understand its structural basis. Methods Fifty postmenopausal women (55–89 years) who had sustained hip fractures due to low-energy trauma underwent QCT scans of the contralateral hip within 3 months of the fracture. For each case, postmenopausal women, matched by age (±5 years), weight (±5 kg) and height (±5 cm), were recruited as controls. We quantified cortical, trabecular and integral vBMD and apparent cortical thickness (AppCtTh) in four quadrants of cross-sections along the length of the femoral head (FH), femoral neck (FN), intertrochanter and trochanter and examined their association with hip fracture. Results Women with hip or intracapsular (IC) fracture had significantly ( p