New Method for Assessing Osteoporosis Risk

Using Radiogrammetry of the Hand to Predict Hip Fractures

illustrated x-ray image of the handCan digital X-ray radiogrammetry (DXR) of the hand or wrist be used as an early predictor of osteoporosis and future hip fracture risk?

A team led by researchers at Karolinska University Hospital in Stockholm, Sweden, examined this question in a study, “Digital X-ray radiogrammetry of hand or wrist radiographs can predict hip fracture risk-a study in 5,420 women and 2,837 men.” The study was published online ahead of print in November 2012. It appears in the journal European Radiology.

The study authors were interested in whether DXR could predict future hip fracture risk by showing a lowered bone mineral density (BMD) in some patients. The researchers gathered 45,538 radiographs (all of patients’ left hands) from 3 emergency hospitals in Stockholm. Radiographs that included foreign material, had unacceptable positioning, included insufficient metacarpal bone, or which had other inadequate data were excluded from the study.

In total, 18,824 radiographs (from 15,072 patients) were analyzed with DXR. Participants aged 40 and older were included in the study. A BMD equivalent (DXR-BMD) was determined and examined against hip fracture incidence in the patients (only new hip fractures were included; patients who had a history of hip fractures prior to the DXR were excluded from the analysis).

Of the examined radiographs, 8,257 patients (approximately 65% female) met the researchers’ inclusion criteria. The results of the study showed that 122 patients suffered from a hip fracture following their radiograph. The patients who did sustain fractures had a lower DXR-BMD than patients who did not have hip fractures.

The researchers conclude that their study results demonstrate that digital X-ray radiogrammetry of the hand/wrist can be used to predict future hip fractures in men and women. They argue that it may be possible to identify osteoporosis in patients who are being assessed for hand or wrist fractures.

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