Ilyas Gokhan, Ipci Fikri Burak
Department of Orthopedics and Traumatology, Faculty of Medicine, Usak University, Usak 64000, Turkey.
Diagnostics (Basel). 2023 Jul 28;13(15):2519. doi: 10.3390/diagnostics13152519.
The aim of the current study is to determine the relationship between osteoporosis findings in plain X-ray and dual-energy X-ray absorptiometry (DXA) measurement results and to create an alternative diagnostic method for osteoporosis without DXA measurement when necessary.
DXA values and hip radiographs of 156 patients were retrospectively analyzed. Singh index (SI), Dorr index (DI), cortical thickness index (CTI), and canal-to-calcar ratio (CCR) measurements from both plain hip radiographs were determined by two observers. The correlation of the DXA parameters (hip total T-score, femoral neck T-score, hip total Z-score, hip total bone mineral density [BMD], and femoral neck BMD) and osteoporosis markers on plain hip radiography (SI, DI, CTI, and CCR) was calculated. In addition, patients were evaluated by dividing them into three groups according to the level of their T-scores (normal, osteopenia, and osteoporosis). In addition, cut-off values were calculated for CTI and CCR.
The mean age was 68.27 ± 8.27 (50-85) years. There was a strong correlation between hip total T-score values and SI, DI, and CTI (r = 0.683, -0.667, and 0.632, respectively), and a moderate correlation (r = -0.495) with CCR. When both hips were compared, there were strong correlations between radiographic parameters (r = 0.942 for SI, 0.858 for DI, 0.957 for CTI, and 0.938 for CCR, all with < 0.001). When patients divided into three groups according to the T-score level were compared in terms of SI, DI, CTI, and CCR, it was found to be directly related to osteoporosis level (all < 0.001). In the differentiation of osteopenia and osteoporosis, the cut-off values were 50.4 degrees for CTI and 60.3 degrees for CCR.
Good correlations between hip total T-score values and SI, DI, CTI, and CCR (r = 0.683, -0.667, 0.632, and -0.495, respectively) indicate that the presence of osteoporosis can be detected by hip radiography findings without DXA.
本研究的目的是确定普通X线片中骨质疏松的表现与双能X线吸收法（DXA）测量结果之间的关系，并在必要时创建一种无需DXA测量的骨质疏松替代诊断方法。
回顾性分析156例患者的DXA值和髋部X线片。由两名观察者确定普通髋部X线片的辛格指数（SI）、多尔指数（DI）、皮质厚度指数（CTI）和髓腔与距骨比值（CCR）。计算DXA参数（髋部总T值、股骨颈T值、髋部总Z值、髋部总骨密度[BMD]和股骨颈BMD）与普通髋部X线片上骨质疏松标志物（SI、DI、CTI和CCR）之间的相关性。此外，根据患者的T值水平将其分为三组进行评估。此外，还计算了CTI和CCR的临界值。
平均年龄为68.27±8.27（50 - 85）岁。髋部总T值与SI、DI和CTI之间存在强相关性（分别为r = 0.683、-0.667和0.632），与CCR存在中度相关性（r = -0.495）。比较双侧髋部时，影像学参数之间存在强相关性（SI为r = 0.942，DI为r = 0.858，CTI为r = 0.957，CCR为r = 0.938，均P < 0.001）。根据T值水平将患者分为三组，并比较其SI、DI、CTI和CCR，发现与骨质疏松程度直接相关（均P < 0.001）。在区分骨质减少和骨质疏松时，CTI的临界值为50.4度，CCR的临界值为60.3度。
髋部总T值与SI、DI、CTI和CCR之间的良好相关性（分别为r = 0.683、-0.667、0.632和-0.495）表明，无需DXA，通过髋部X线片表现即可检测出骨质疏松的存在。
