Is bone mineral density lower in the necrotic lesion in pre‐collapse osteonecrosis of the femoral head?

The purpose of this study was to clarify whether bone mineral density (BMD) of the necrotic lesion in precollapse osteonecrosis of the femoral head (ONFH) is reduced according to Hounsfield unit (HU) values on computed tomography (CT). The superior one‐third of the femoral head in the coronal sectio...

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Bibliographic Details
Published in:Journal of orthopaedic research 2020-11, Vol.38 (11), p.2434-2442
Main Authors: Baba, Shoji, Motomura, Goro, Ikemura, Satoshi, Yamaguchi, Ryosuke, Utsunomiya, Takeshi, Hatanaka, Hiroyuki, Kawano, Koichiro, Xu, Mingjian, Nakashima, Yasuharu
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Adult
Aged
Aged, 80 and over
Bone Density
bone mineral density
dual‐energy X‐ray absorptiometry
Female
Femur Head - diagnostic imaging
Femur Head Necrosis - diagnostic imaging
Hounsfield unit
Humans
Male
Middle Aged
osteonecrosis of the femoral head
propensity score matching
Reference Values
Retrospective Studies
Tomography, X-Ray Computed - methods
Young Adult
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Summary:The purpose of this study was to clarify whether bone mineral density (BMD) of the necrotic lesion in precollapse osteonecrosis of the femoral head (ONFH) is reduced according to Hounsfield unit (HU) values on computed tomography (CT). The superior one‐third of the femoral head in the coronal section was set as the region of interest (ROI) for the measurement of HU values. First, HU values of 101 control participants were assessed to identify relevant confounding factors. Next, the relationship between HU values and BMD on dual‐energy X‐ray absorptiometry (DXA) was verified. Then the mean HU value of the ROI in patients with pre‐collapse ONFH was compared with that in propensity score‐matched control participants. Finally, the HU values of the lateral boundary in the patients with and without subsequent collapse were compared. Multivariable analysis showed that both age and BMI were significantly correlated with the HU value, which showed a strong correlation with the BMD of the femoral neck on DXA (r = 0.92). In 25 ONFH patients and 25 propensity‐matched control participants, no significant difference was found in the HU value of the ROI (p = .54). The mean HU value of the lateral boundary in patients with subsequent collapse was found to be significantly higher than that in patients without subsequent collapse (p 
ISSN:0736-0266
1554-527X
DOI:10.1002/jor.24674