Radiology, Vol 209, 525-530, Copyright © 1998 by Radiological Society of North America
Trochanteric hip fracture: strong association with spinal trabecular bone mineral density measured with quantitative CT
TF Lang, P Augat, NE Lane and HK Genant
Department of Radiology, University of California, San Francisco 94143- 1250, USA.
PURPOSE: To determine the discriminatory capability for hip fracture of
trabecular and integral bone mineral density (BMD) measured with
quantitative computed tomography (CT) of the spine. MATERIALS AND METHODS:
Fifty-six women who had sustained hip fractures and 59 control subjects
underwent volumetric quantitative CT of L1 and L2 and dual x- ray
absorptiometry of the hip. BMD was measured in vertebral regions of
interest that encompassed trabecular, cortical, and integral bone. Logistic
regression analysis was applied to each BMD measure to derive age-,
weight-, and height-adjusted relative risk (RR) factors for overall hip
fracture and for trochanteric fracture and cervical fracture separately.
RESULTS: Spinal trabecular BMD was modestly related to overall hip fracture
(RR, 1.4-1.7; P < .05) and strongly associated with trochanteric
fracture (RR, 4.2-4.5; P < .005). Spinal integral BMD related similarly
to overall hip fracture (RR, 1.7-1.8; P < .05) but more weakly to
trochanteric fracture (RR, 2.3-3.2; P < .01). No spinal BMD measures
were significantly related to cervical fracture. BMD at the hip was
strongly related to overall hip fracture (RR, 3.3- 4.3; P < .001),
cervical fracture (RR, 2.7-5.3; P < .001), and trochanteric fracture
(RR, 2.9-7.2; P < .001). CONCLUSION: Spinal trabecular BMD is strongly
associated with both trochanteric and vertebral fractures.
