New Method Shows Risk of Hip Fracture

Photo: Hand X-Ray

The new technique DXR allows to assess the
risk of osteoporosis and hip fracture better
than other techniques; ©
gualtiero boffi

The researchers believe that X-ray radiogrammetry (DXR), which is fully comparable with other, more costly methods, can be used preventively to identify people in the risk zone for osteoporosis – a disease estimated to effect some 200 million women worldwide.

Each year, approximately 1.7 million hip fractures occur worldwide (about 18,000 only in Sweden), mainly in elderly people and women with osteoporosis. A hip fracture can be particularly serious for the elderly. It often entails lengthy rehabilitation and leaves many patients unable to lead an independent life. Moreover, between 10 and 20 per cent of sufferers die from complications. Apart from the human suffering they cause, hip fractures are also very costly to the healthcare services in the amount of care they demand.

"If we can identify people with osteoporosis and treat them with drugs, we can reduce the risk of hip fracture," says Associate Professor Torkel Brismar of Karolinska Institutet’s Department of Clinical Sciences, Intervention and Technology. "Our research shows that DXR is a technique that lends itself well to this, maybe at general health check-ups, or screenings, for example, or when people seek treatment for a suspected hand or wrist fracture."

For the present study the researchers analyzed digital hand X-rays taken at three hospitals in Stockholm between 2000 and 2008. Their databank included pictures from over 8,000 men and women aged forty years and up. They used DXR to assess bone density in the hand, and by searching in the National Board of Health and Welfare fracture registry they were able to study the link between bone density in the hand and the risk of hip fracture.

Analysis of the sub-group of 122 patients who had suffered a post-X-ray hip fracture showed that they had significantly lower bone density than those who had not had a hip fracture, a result that held up also when adjusted for age. The DXR technique uses a normal X-ray of the hand to analyze the thickness and texture, for example small variations in density, of the metacarpal bones. The analysis is automatic and includes around 1,000 measurements. The standard method of measuring bone density is currently dual-energy X-ray absorbtiometry (DXA).

In this study, the researchers showed that DXR is at least as effective as DXA, which means that the former might one day be an important feature of osteoporosis examinations, for example as part of a general screening. Several pilot projects are underway in several counties to ascertain whether DXR screening of bone density is a useful way of preventing hip fractures.; Source: The Swedish Research Council