Usefulness of hip BMD and geometry as diagnostic methods to predict hip fracture en women

SEIJO M; BAGUR A; SOLIS F; MAUTALEN C; OLIVERI B

Buenos Aires Argentina

Congreso; Reunión Anual de la Asociación Argentina de Osteología y Metabolismo Mineral; 2005

Asociación Argentina de Osteología y Metabolismo Mineral

20 Usefulness of hip BMD and geometry as diagnostic methods to predict hip fracture in women M. Seijo, A. Bagur, F. Solý´s, C. Mautalen, B. Oliveri Osteopatý´as Me´dicas and Seccio´n Osteopatý´as Me´dicas, Hospital de Clý´nicas, Buenos Aires, Argentina Objectives: (1) To study the differences in hip BMD and geometry (FG) between healthy post menopausal women (PMPW) and PMPW with HF. (2) To evaluate whether hip axis length (HAL) is a good predictor for HF. (3) To compare hip BMD and FG of osteoporotic women with trochanteric HF (T HF) versus cervical HF (C HF). Population: Contralateral hips were studied in 18 PMPW with recent atraumatic HF. The average age was 70 T 8 years (58–88 years). The control group (C) comprised 71 PMPW in the same age range. BMD and FG were evaluated by DXA (Lunar Prodigy). Were determined: BMD of femoral neck (FN), Ward triangle (W), trochanter (T), total femur (TF), upper FN (UFN) and lower FN (LFN), HAL, cross sectional moment of inertia (CSMI), and cross sectional areas (CSA). Patients with HF were taller (1.57 T 0.1 vs. 1.53 T 0.1 m, P < 0.05), weighed less (62.6 T 10.7 vs. 68.3 T 4.2 kg, P < 0.02) and BMI was lower (25.4 T 2.9 vs. 29.2 T 4.2, P < 0.05) than C. HF patients had a decrease in all femoral areas BMD compared with C (11 to 25%, P < 0.0001). The decrease of BMD was greatest at the UFN (_23%). The T also showed a greater diminution in BMD compared with the other areas (_25%). HAL was greater in HF patients (+8 mm). T HF were older (82.4 T 2.8 vs. 70.3 T 8.2 years, P < 0.0004), weighed less (59.2 T 10.6 vs. 66.4 T 9.2 kg, P < 0.002) and were shorter (_9 cm) than C HF. BMD of all femoral areas was lower in T HF patients (¨_5%, p NS). Conclusions: 1— The decrease in BMD was greatest at the UFN (_23%), which is where the fracture may start. In femoral areas, the trochanter had the greatest decrease in BMD (_25%). 2— HAL was greater in patients with HF. 3—An index combining BMD and FG may prove to be a useful predictor of HF. doi:10.1016/j.bone.2006.02.0