DUAL-ENERGY X-RAY ABSORPTIOMETRY AS AN INDICATOR FOR FRAGILITY FRACTURE RISKS OF THE FEMORAL NECK

Objective: Bone loss is a major complication of primary hyperparathyroidism (PHPT), and the extent of bone loss is an important factor for parathyroidectomy. Studies focused on this issue of bone loss in subjects with PHPT are quite rare in our country. This study will help the physicians to take proper action by giving an exact reflection of bone condition in subjects with PHPT. The purpose of this study was to evaluate the bone condition by measuring Bone Mineral Density (BMD), in subjects with PHPT using Dual Energy X-ray Absorptiometry (DEXA) and compare these findings with individuals without PHPT.Patients and Methods: It was an analytic cross sectional study (group comparison) carried out at National Institute of Nuclear Medicine and Allied Sciences (NINMAS) BSMMU campus, Dhaka from July 2015-December 2016. Subjects of PHPT diagnosed by biochemical evaluation (increased serum calcium and parathyroid hormone concentrations), between age ranges 15-45 years were selected as group-A. Individuals without biochemical evidence of PHPT or other major illness causing bone loss were selected as comparison group or as group-B. The subjects underwent BMD test by DEXA at lumbar spines from L1-L4 vertebra and the left femoral neck using Norland XR-46 densitometer. BMD was classified according to WHO criteria. Data presented on categorical form were analyzed using chi-squared test. While the data presented on continuous scale were analyzed using student’s t-test. In each analysis, level of significance was 5% and P value <0.05 was considered significant. Data were processed and analyzed with the help of computer software SPSS, version 20.Results: Total number of 90 subjects were selected for this study, 45 subjects with PHPT were in group-A and equal number of subjects without PHPT were in group-B. The findings derived from data analysis showed, a significantly more male participants in group-A. The mean age of group-A and group-B was 37.24 ± 8.03 years and 38.20 ± 5.74 years respectively. Mean BMI of group-A was 25.10 ± 4.35 kg/m2 in compare to 29.43 ± 5.17 kg/m2 in group-B. Higher BMI was noted in both groups. PHPT subjects with high BMI had low BMD. BMD expressed in absolute value (gm/cm2) and T score. BMD was significantly low in group-A (with PHPT) than in group-B (without PHPT), (p<0.0001). In group-A, prevalence of low BMD was 62.2% (osteopenia 37.8% and osteoporosis 24.4%) at lumbar spine and 84.5% (osteopenia 35.6% and osteoporosis 48.9%) at femoral neck. PHPT subjects had significant difference in both T score and BMD between lumbar spine and femoral neck.Conclusion: Primary hyperparathyroidism (PHPT) is shown to be associated with significantly reduced BMD especially at femoral neck. Thus, an increased fracture risk should consider if it is left untreated.Bangladesh J. Nuclear Med. 20(2): 129-135, July 2017

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Structural Trends in the Aging Femoral Neck and Proximal Shaft: Analysis of the Third National Health and Nutrition Examination Survey Dual-Energy X-Ray Absorptiometry Data

Journal of Bone and Mineral Research ◽

10.1359/jbmr.2000.15.12.2297 ◽

2000 ◽

Vol 15 (12) ◽

pp. 2297-2304 ◽

Cited By ~ 307

Author(s):

Thomas J. Beck ◽

Anne C. Looker ◽

Christopher B. Ruff ◽

Harri Sievanen ◽

Heinz W. Wahner

Keyword(s):

Femoral Neck ◽

National Health ◽

Dual Energy ◽

Nutrition Examination Survey ◽

X Ray ◽

The Third ◽

Health And Nutrition

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Dual Energy X-Ray Absorptiometry (DEXA) in Evaluation of the Proximal Femur after Repair of Proximal Femoral Physeal Fractures in Immature Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632447 ◽

1995 ◽

Vol 08 (03) ◽

pp. 153-158 ◽

Cited By ~ 3

Author(s):

D. M. Tillson ◽

R. M. McLaughlin ◽

Ph. W. Toll ◽

D. C. Richardson ◽

J. K. Roush

Keyword(s):

Bone Mineral Density ◽

Femoral Neck ◽

Bone Mineral ◽

Dual Energy ◽

Clinical Findings ◽

Fracture Repair ◽

Volumetric Bone Mineral Density ◽

Mineral Density ◽

X Ray ◽

Physeal Fractures

SummaryThin slices of the proximal femora of twelve immature dogs were examined with dual energy x-ray absorptiometry, after surgical creation and repair of proximal femoral physeal fractures. A protocol for the subtraction of microvascular barium sulphate was used to eliminate interference from the barium with the determination of bone mineral content (BMC), bone mineral density (BMD) and volumetric bone mineral density (VBMD). The results showed there was a significant decrease in the BMC (four and eight weeks) and BMD (eight weeks) for the entire proximal femora of the operated side when compared to the non-operated side. Significant decreases were also seen for the BMC of the physeal region at week eight and the VBMD of the metaphyseal area in the two week femora. The findings with DEXA support the clinical findings of femoral neck thinning in proximal femoral physeal fractures that are surgically repaired. The DEXA findings suggest that the quality of the bone of the femoral neck is less as shown by the decreased BMC, BMD and VBMD. Postoperative complications may occur at a higher frequency when such quality changes occur.Dog proximal femora were examined with DEXA after surgical creation and repair of proximal femoral physeal fractures. DEXA findings support clinical findings of femoral neck thining after fracture repair.

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Comparison of Bone Mineral Density at Hip and Lumbar Spine in Patients with Femoral Neck Fractures and Pertrochanteric Fractures

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0014.7567 ◽

2021 ◽

Vol 23 (1) ◽

pp. 45-49

Author(s):

Chulin Chewakidakarn ◽

Varah Yuenyongviwat

Keyword(s):

Lumbar Spine ◽

Femoral Neck ◽

Hip Fractures ◽

Dual Energy ◽

Femoral Neck Fractures ◽

University Hospital ◽

Mineral Density ◽

Pertrochanteric Fractures ◽

X Ray ◽

Total Hip

Background. Geriatric hip fractures, including femoral neck and pertrochanteric fractures, are common nowadays, which is related to increasing numbers of elderly people worldwide. Osteoporosis is an important risk factor associated with hip fractures. This study aimed to describe the association of hip fractures and osteoporosis at different BMD measurement sites and determine any differences between these two types of hip fracture. Material and methods. A retrospective study conducted in a university hospital in the south of Thailand enrolled 223 patients aged over 50 years with low-energy trauma hip fractures. Each patient had undergone dual energy x-ray absorptiometry (DXA) within 2 weeks of injury. T-scores were recorded for the total hip, femoral neck and lumbar spine areas and classified as normal, osteopenia and osteoporosis according to WHO osteoporosis diagnostic criteria. Results. The highest proportion of T-scores in the osteoporotic range were registered at the femoral neck (68.6%) compared to total hip (52.9%) and lumbar spine (47.7%). At least 31.4% of patients were in the non-osteoporotic range. No significant differences were found at all sites of BMD measurement between the two types of fracture. Conclusions. 1. At least 1/3 of patients with geriatric hip fractures had their T-scores in the normal to osteopenic range. 2. BMD in different areas is not different between types of hip fractures.

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