Evaluation of the Singh index and femur geometry in osteoporotic women

Open Medicine ◽  
2010 ◽  
Vol 5 (5) ◽  
pp. 601-610
Author(s):  
Özlen Karabulut ◽  
Mehmet Tuncer ◽  
Zülfü Karabulut ◽  
Eyüp Hatipoğlu ◽  
Hasan Nazaroğlu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Physical Therapist ◽  
Statistical Tests ◽  
Femoral Shaft ◽  
Mineral Density ◽  
Singh Index ◽  
Axis Length ◽  
The Right ◽  
Neck Diameter ◽  
Femur Geometry

AbstractWe aimed to compare the Singh index with bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), body mass index (BMI) and femur geometry in the right proximal femur of osteoporotic women, using different statistical tests. Radiographs of each patient were assessed to determine the Singh index by five observers. The observers consisted of a consultant radiologist, physical therapist and anatomists who studied the series of radiographs. They were asked to apply the Singh index by comparing the trabecular bone pattern in the proximal right femur with the reference scale published by Singh et al. [1]. This has a six point scale from grade VI to grade I. We evaluated 47 osteoporotic women in this study. The subjects’ mean age, weigth, and height were 63,21 ± 10,106, 66,72 ± 12.523, 154,94 ± 7,026 respectively. We found a significant relationship between the Singh index and BMD. The Singh index correlated significantly with hip axis length, femoral neck diamater and trochanteric width. And, BMD correlated significantly with femoral head and neck diameter, femoral neck cortex width, medial calcar femoral cortex width and femoral shaft cortex width. The evaluation of the Singh index grades in its self, there was a significant relation among them.

scholarly journals Radiofrequency Multi Echographic Spectrometry (REMS) Technology in Patients With Bone Artifacts

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A249-A249
Author(s):  
Maria Dea Tomai Pitinca ◽  
Carla Caffarelli ◽  
Stefano Gonnelli
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Fracture ◽  
Gamma Nail ◽  
Mineral Density ◽  
Left Femur ◽  
Diagnosis Of Osteoporosis ◽  
T Score ◽  
Femoral Site ◽  
The Right

Abstract Introduction: Dual-energy X-ray Absorptiometry (DXA) is considered the gold standard examination for the evaluation of bone mineral density (BMD). However, it is known that some conditions, such as arthrosis, vertebral collapse, or vertebroplasty, result in an overestimation of the BMD measured by DXA. Conversely, Radiofrequency Echographic Multi-Spectrometry (REMS) technology is able to automatically discard signals related to bone artifacts, such as calcifications or osteophytes, thanks to the identification of unexpected spectral features (Diez-Perez et al. 2019). The aim of this work is to assess the performance of REMS technology in patients with bone alterations that could alter the densitometric examination. Materials: The bone densitometry exams, both REMS and DXA, of patients with evidences of bone alterations at lumbar vertebrae or femoral neck were analysed. Written patient informed consent was obtained before the scans. Results: Eighty-seven patients with spinal artifacts, including 22 patients with vertebroplasty, 26 patients with bone fracture and 38 patients with osteo-arthrosis were considered. At lumbar spine, the mean BMD and T-score values assessed by REMS was lower than the ones measured by DXA. Moreover, the results obtained by the two technologies were not correlated. On the contrary, the BMD and T-score values measured by REMS and DXA at the femoral site were highly correlated (p<0.01), as well as BMD and the T-score values measured by DXA at the femoral neck and by REMS at the lumbar spine (p<0.01). As concerning artifacts involving femoral site, a patient with an intramedullary gamma nail positioned following a displaced pertrochanteric fracture of the left femur underwent a DXA scan of the right femur and a REMS scan of both femurs. A diagnosis of osteoporosis at the right femur was posed by both technologies. At the left femur with intramedullary gamma nail, REMS only made a diagnosis of osteoporosis highly corresponding with the one performed at right femur. Conclusions: The results from the patient series with spinal artifacts and the clinical case with femoral intramedullary gamma nail show the ability of REMS to evaluate anatomical sites that would not be assessable by DXA, such as in case of implanted nails, or that would give unreliable higher BMD values, such as in case of vertebroplasty, osteo-arthrosis and bone fracture. References: Diez-Perez et al. Aging Clin Exp Res 2019;31(10):1375–89

scholarly journals Low Bone Mineral Density and Calcium Levels as Risks for Mortality in Patients with Self-Discontinuation of Anti-Osteoporosis Medication

2021 ◽  
Vol 19 (1) ◽  
pp. 197
Author(s):  
Chun-Sheng Hsu ◽  
Shin-Tsu Chang ◽  
Yuan-Yang Cheng ◽  
Hsu-Tung Lee ◽  
Chih-Hui Chen ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Mortality Risk ◽  
Calcium Level ◽  
Cox Regression ◽  
Mass Density ◽  
Bone Mass Density ◽  
Mineral Density ◽  
Osteoporosis Medication ◽  
The Right

Bone mass density (BMD) has been used universally in osteoporosis diagnosis and management. Adherence to anti-osteoporosis medication is related to mortality risk. This study aimed to investigate the relationship between mortality and low BMD of the femoral neck and vertebra among patients self-discontinuing anti-osteoporosis medication. Between June 2016 and June 2018, this single-center retrospective study recruited 596 participants who self-discontinued anti-osteoporosis medication. Patients were categorized into four groups by BMD of the right femoral neck and lumbar spine. Occurrence and causes of mortality were obtained from medical records. Independent risk factors and the five-year survival of various levels of BMD were analyzed by Cox regression and the Kaplan–Meier survival analysis. BMD value and serum calcium level were significantly lower in the mortality group (p < 0.001). Compared to the reference, the adjusted hazard ratio (HR) for all-cause mortality in patients with lower BMD of both the lumbar spine and femoral neck was 3.03. The five-year cumulative survival rate was also significantly lower (25.2%, p < 0.001). A low calcium level was also associated with mortality (HR: 0.87, 95% CI: 0.76–0.99, p = 0.033). In conclusion, lower BMD and calcium levels were associated with higher mortality risk in patients with poor adherence. Hence, patients self-discontinuing anti-osteoporosis medication should be managed accordingly.

scholarly journals Preoperative and Postoperative Bone Mineral Density Change and Risk Factor Analysis in Patients with a GH-Secreting Pituitary Adenoma

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Li’nan Qin ◽  
Xiaopeng Guo ◽  
Lu Gao ◽  
Zihao Wang ◽  
Chenzhe Feng ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Pituitary Adenomas ◽  
Disease Duration ◽  
Femoral Shaft ◽  
Mineral Density ◽  
Total Hip

Purpose. This study analysed changes in bone mineral density (BMD) at different sites in patients with acromegaly and postoperative BMD changes and explored risk factors associated with BMD. Methods. Clinical data of 39 patients with growth hormone- (GH-) secreting pituitary adenomas and 29 patients with nonfunctioning pituitary adenomas who were newly diagnosed in neurosurgery from January 2016 to December 2018 were retrospectively analysed, including measurements of preoperative and postoperative BMD, serum GH glucose inhibition, random GH and IGF-1, and other anterior pituitary hormones. Results. The average patient age and disease duration were 43.74 (33.41–54.07) years and 72.15 (22.82–121.48) months, respectively. Compared with patients with nonfunctioning adenomas, patients with GH-secreting pituitary adenomas had significantly higher BMDs at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites (p<0.05). The BMD Z score at L1 and femoral neck sites significantly increased (p<0.05). Thirteen patients underwent re-examination of BMD 1 year postsurgery, and the BMD Z score was reduced to normal levels at L1, L2, L3, L4, L1-L4, and L2-L4 compared with preoperative levels (p<0.05). Postoperative BMD Z scores in the femoral neck and total hip were significantly increased (p<0.05). Disease duration was negatively correlated with the lumbar-spine BMD Z score. IGF-1 burden was negatively correlated with the BMD Z score at L1 and L1–L4. Multiple regression analysis showed that IGF-1 burden was a risk factor for a BMD Z score decrease at L1 and L1–L4. Conclusion. BMD in patients with GH-secreting pituitary adenomas (compared with nonfunctional adenomas) increased at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites. Lumbar-spine BMD Z score recovered to normal levels postsurgically when GH and IGF-1 levels were controlled. BMD Z score was negatively correlated with disease duration and IGF-1 burden in patients with GH-secreting pituitary adenomas, and IGF-1 burden was an independent risk factor for reduced lumbar-spine BMD Z score.

scholarly journals AB0609 RADIOFREQUENCY ECHOGRAPHIC MULTI-SPECTROMETRY FOR THE ASSESSMENT OF BOTH FEMORA IN PREGNANT WOMEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1340.1-1340
Author(s):  
E. Kirilova ◽  
N. Kirilov ◽  
S. Vladeva
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Pregnant Women ◽  
Bone Mineral ◽  
Dual Energy ◽  
Z Score ◽  
Mineral Density ◽  
X Ray ◽  
The Mean ◽  
The Right

Background:Radiofrequency Echographic Multi-Spectrometry (REMS) is a non-ionizing innovative approach for the assessment of REMS-based bone mineral density (BMD) of the axial skeleton. The principle of the REMS technology is based on the analysis of native raw unfiltered ultrasound signals during an echographic scan of the lumbar spine or the femoral neck [1]. Several studies demonstrated the high concordance with dual energy X-ray absorptiometry (DXA) in terms of measured BMD with this novel technology [2,3]. In previous published literature it was envisaged to apply this technology for the examination of the axial bone density in pregnant women. Pregnancy-associated bone loss has been demonstrated as decreased bone mineral density (BMD) in previous studies [4].Objectives:The aim of the current study is to compare the BMD values of both femora between pregnant and non-pregnant women matched for age and BMI using the novel REMS technology.Methods:Of total fifty women twenty pregnant women (40%) and thirty non-pregnant women (60%) were included in the study. The mean age of the pregnant women was 32 years ± 5 standard deviations (SD), (range 25-41 years) and the mean age of the non-pregnant women was 30 years ± 6 standard deviations (SD), (range 24-39 years). REMS approach was used to assess REMS-based BMD and REMS-based Z-score values of the femoral neck. Furthermore, body mass index (BMI) and gestational age in weeks were evaluated.Results:The mean BMI of the pregnant women was 26 kg/m2 ± 7 kg/m2 (range 14 kg/m2-42 kg/m2) and those of the non-pregnant women was 25 kg/m2 ± 5 kg/m2 (range 16 kg/m2-35 kg/m2). The mean gestational age was 20 weeks’ gestation ± 5 weeks’ gestation (range 13-27 weeks’ gestation). REMS-based mean BMD of the left femoral neck of the pregnant women was 0.793 g/cm2 ± 0.167 g/cm2 (range 0.563 g/cm2-1.154 g/cm2). REMS-based mean BMD of the right femoral neck of the pregnant women was 0.828 g/cm2 ± 0.153 g/cm2 (range 0.570 g/cm2-1.161 g/cm2). After comparing left femoral neck BMD with the right femoral neck BMD of the pregnant women, we found a linear correlation (R=0.764). Left femoral neck BMD value (0.793 g/cm2) of the pregnant women was significantly lower than those of the non-pregnant women (0.854 g/cm2), p=0.002. The mean left femoral Z-score of the pregnant women (-0.1 SD with range -2.5 SD-2.9 SD) was also significantly lower compared to those of the non-pregnant women (1.2 SD with range -1.5 SD-3.1 SD), p=0.003.Conclusion:This is the first study which provides data about BMD and Z-score values of both femora in pregnant women assessed with the radiation-free REMS technology. Pregnant women demonstrated significantly lower femoral neck BMD values and Z-scores compared to those of the non-pregnant women. Innovative REMS method could be very helpful for making decision about the treatment of pregnant women who are at risk of lower BMD due to concomitant diseases and/or treatment associated with osteoporosis.References:[1]Casciaro S, Conversano F, Pisani P, Muratore M. New perspectives in echographic diagnosis of osteoporosis on hip and spine. Clin Cases Miner Bone Metab. 2015; 12(2):142-150.[2]Nikolov M, Nikolov N. AB0908 Assessment of the impact of the lean mass with body composition by dual-energy x-ray absorptiometry on the bone mineral density. Annals of the Rheumatic Diseases 2020; 79:1756.[3]Chakova M., Chernev D., Kashukeeva P., Krustev P., Abedinov F. Lumbar Sympathectomy - Literature Review. International Journal of Science and Research (IJSR) Volume 7 Issue 8, August 2018 ISSN (Online): 2319-7064.[4]Degennaro, V. A.; Cagninelli, G.; Lombardi, F. A. “VP34.12: First assessment of maternal status during pregnancy by means of radiofrequency echographic multi-spectrometry technology”. Ultrasound in Obstetrics & Gynecology. 2020, 56 (S1): 199.Disclosure of Interests:None declared.

scholarly journals Change in Bone Mineral Density in Post Menopausal Women with Rheumatoid Arthritis

2013 ◽  
Vol 12 (2) ◽  
pp. 158-163
Author(s):  
Mehrdad Aghaei ◽  
Sima Sedighi ◽  
Naser Behnampour ◽  
Sharabeh Hezarkhani ◽  
Mona Shirashiani ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Statistical Tests ◽  
Mineral Density ◽  
Menopausal Women ◽  
Duration Of Disease ◽  
Post Menopausal

Introduction: Low bone mass is a serious complication of post menopausal women with rheumatoid arthritis. We determined the Change in Bone Mineral Density in postmenopausal women with rheumatoid arthritis. Methods: This retrospective cohort study was carried out on consecutive postmenopausal women with rheumatoid arthritis who were referred to the Azar 5th teaching hospital affiliated to Golestan University of Medical Sciences, North of Iran in 2009. The required data were gathered from the patients’ medical records. The data were analyzed using SPSS software and statistical tests. Results: We studied 98 postmenopausal women with rheumatoid arthritis. Mean number of years since menopause and mean duration of disease were 9.39 and 5.13 respectively. T Score mean in femoral neck and lumbar spines was -1.45±1.26 and -2.45±1.44 respectively. The overall prevalence of osteoporosis at both the lumbar spine and femoral neck was 13.3. We have found a significant correlation between age, duration of disease, duration of menopause and bone mineral density (P-Value<0.01). Conlusion: Our results indicate a negative effect of age, number of years since menopause and duration of disease on bone mineral density. So, BMD should be measured in high risk women prior to the implementation of any treatment or prevention program. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 158-163 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14944

Disparate decrease of blood perfusion among femoral head, femoral neck and femoral shaft in patients with decreased bone mineral density

Bone ◽  
2008 ◽  
Vol 43 ◽  
pp. S67
Author(s):  
Yi-Xiang Wang ◽  
James F. Griffith ◽  
Anthony Kwok ◽  
David K.W. Yeung ◽  
Jason Leung ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Femoral Head ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Femoral Shaft ◽  
Blood Perfusion ◽  
Mineral Density

Effect of denosumab on bone mineral density (T-score classification of −1.0 to −2.5) in postmenopausal Japanese women receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 552-552
Author(s):  
Katsuhiko Nakatsukasa ◽  
Takayuki Matsuda ◽  
Tetsuya Taguchi
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
Prospective Study ◽  
Hormone Receptor ◽  
Mineral Density ◽  
Hormone Receptor Positive ◽  
The Right

552 Background: Adjuvant aromatase inhibitor (AI) therapy is well established in postmenopausal women with hormone receptor-positive breast cancer, but such therapy is associated with bone loss and increased fracture risk. Denosumab, a fully human monoclonal antibody against receptor of nuclear-κB ligand, was previously proven to protect against AI-induced bone loss. In Japan, however, the efficacy of denosumab in the treatment of AI-associated bone loss has not been proven in a prospective study. Methods: This non-randomized prospective study was conducted at four institutions in Japan. we prospectively evaluated the bone mineral density (BMD) of the lumbar spine and bilateral femoral neck in hormone-receptor positive clinical stageⅠ–ⅢA, postoperative postmenopausal breast cancer patients who were scheduled for treatment with AI as adjuvant endocrine therapy or during AI adjuvant therapy. They received supplemental calcium, vitamin D and subcutaneous denosumab 60mg (n=103) every six months. At enrollment, all patients were required to have evidence of low bone mass, excluding osteoporosis. The primary endpoint was percentage change in lumbar spine BMD from baseline to month 12. The secondary endpoint was percentage change in bilateral femoral neck BMD from baseline to month 12. This is the first trial where the right and left femoral neck BMD are measured separately. Results: We enrolled 103 patients between November, 2014 to October, 2016. At 12 months, lumber spine BMD increased by 4.7 %. The patients who were administered prior AI therapy (n=60) had a 4.8 % increase, and the patients without prior AI therapy (n=40) had a 4.6 % increase. At 12 months, the right and left femoral neck BMD increased by 2.9 % and 2.0 %, respectively. Hypocalcemia ≥ grade2, osteonecrosis of the jaw (ONJ) and non-traumatic clinical fracture were absent in this study. Conclusions: Twice-yearly treatment with denosumab was associated with consistently greater gains in BMD among Japanese women receiving adjuvant AI therapy, regardless of whether prior AI therapy was administered. Clinical trial information: UMIN000013863.

scholarly journals Does Proximal Hip Geometry Affect Fracture Type in The Elderly Population?

2021 ◽  
Author(s):  
Emrah Sayit ◽  
Nizametin Guzel ◽  
Asli Tanrivermis Sayit
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Axial Length ◽  
Femoral Shaft ◽  
Length Ratio ◽  
Fracture Type ◽  
Head Diameter ◽  
Femoral Head Diameter ◽  
Shaft Diameter ◽  
Neck Diameter

Abstract Background The aim of this study was to determine the differences in proximal femoral geometric (PFG) parameters between patients with femoral neck fractures(FNFs) and patients with intertrochanteric fractures (ITFs). Methods We retrospectively evaluated 114 patients (33 FNFs, 81 ITFs.) who were hospitalized secondary to hip fractures. Patients were divided into two groups: patients with FNFs and patients with ITFs. The PFG parameters (the neck shaft angle, center-edge angle, femoral head diameter, femoral neck diameter, neck/head ratio, femoral neck axial length, femoral shaft diameter, hip axial length, and neck/hip length ratio) were measured on the hip joint radiographs. Results There were no statistically significant differences in age and gender between the FNF and ITF groups. In addition, there were no statistically significant differences in the PFG parameters between the FNF and ITF groups except in the neck/hip length ratio (NHLR) (0.86 ± 0.03 vs 0.84 ± 0.03, p = 0.05). When a 3-way multivariate analysis was performed according to gender, fracture type, and fracture site, the femoral head diameter, femoral neck diameter, femoral neck axial length, femoral shaft diameter, hip axial length, and NHLR were found to be greater in females than in males, and a statistically significant relationship was found between gender and these variables. Conclusion Only the NHLR was significantly higher in the ITF group, so this study revealed that a higher NHLR, which is the presence of a longer hip axis combined with a shorter neck axis, is a risk factor for ITF after a minor trauma.

scholarly journals The correlation of Singh index and cortical thickness index toward bone mineral density in women older than 60 years old with femoral neck fracture

2021 ◽  
Vol 9 (5) ◽  
pp. 1270
Author(s):  
Dwijo Purboyo ◽  
K. G. Mulyadi Ridia ◽  
I. G. N. Wien Aryana ◽  
Putu Astawa ◽  
I. Wayan Suryanto Dusak ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Cortical Thickness ◽  
Negative Impact ◽  
Proximal Femur Fracture ◽  
Mineral Density ◽  
Female Patients ◽  
Singh Index ◽  
Neck Fracture ◽  
Cortical Thickness Index

Background: Femoral neck fracture is one of the most common fractures in elderly. Proximal femur fracture in elderly patients is considered a severe morbidity which has a negative impact on the life expectancy and quality of life. Aim of this study was to find the correlation of cortical thickness index (CTI) and SI toward bone density (BMD) in female patients over 60 years of age with femoral neck fracture.Methods: This is an observational cross-sectional study. Subjects were selected from Sanglah general hospital outpatient department, Denpasar, Bali during the period October 2020 to January 2021 by inclusion requirements and then randomized into two groups. Data were taken through history taking, physical examination as well as supporting investigations such as contralateral hip joint radiograph and BMD measurements. Statistical analysis was done from those data.Results: It has been obtained that there was a positive correlation of Singh index (SI) and CTI toward BMD. The correlation coefficient (r) between SI and BMD was 0.874 (p=0.000). The r between CTI and BMD was 0.854 (p=0.000). Both variables were significant.Conclusions: There were significantly strong correlations between SI and BMD (r=0.874, p=0.00), also CTI and BMD (r=0.854, p=0.00) in female patients over 60 years of age with femoral neck fracture.

scholarly journals A COMPARATIVE STUDY OF NECK SHAFT ANGLE OF FEMUR IN CENTRAL INDIAN POPULATION

2021 ◽  
pp. 1-3
Author(s):  
Vivek Kumar ◽  
Vivekanand Murlidhar Gajbhiye
Keyword(s):  
Femoral Neck ◽  
Indian Population ◽  
Femoral Shaft ◽  
Mean Value ◽  
Developmental Dysplasia ◽  
Neck Shaft Angle ◽  
Geographical Variations ◽  
Shaft Angle ◽  
The Mean ◽  
The Right

Background: In the fields of forensics, anthropology, orthopaedics, and human kinematics, the thigh bone femur is widely studied. The clinical significance of the femoral neck shaft angle lies in the diagnosis, treatment and monitoring of femoral neck fractures, trochanteric fractures, slipped upper femoral epiphysis, and hip developmental dysplasia. Objective: The present study was conducted to compare the NSA disparity between femurs on both sides and to compare the NSA with the Western and Indian population sizes of different regions. This research therefore leads to Indian data on these parameters. Materials and Methods: A total of 150 (75 right and 75 left) dry femur were used for measuring the neck shaft angle. Unpaired t-test was used to compare right and left femora. Results: The mean value of neck shaft angle was 126.04±5.05°. It ranges between 1130 to 1360. The mean value of right side was 125.92±4.9° and left side was measured 127.43±5.2°. There was no significant correlation between right and left neck shaft angle. Conclusion: The mean left femoral neck shaft angle was higher than the right femoral shaft in the present analysis, but the values were not statistically important. The angle of the neck shaft was lower than most studies in the Western population, but it was similar to most other studies in India. In the Indian population, geographical variations in the angle of the neck shaft also occur. In the field of orthopaedic surgery and anthropometry, this research will be of benefit.

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