Cortical Thickness Mapping to Identify Focal Osteoporosis in Patients with Hip Fracture

Hdl Handle:
http://hdl.handle.net/10675.2/797
Title:
Cortical Thickness Mapping to Identify Focal Osteoporosis in Patients with Hip Fracture
Authors:
Poole, Kenneth E.S.; Treece, Graham M.; Mayhew, Paul M.; Vaculí­k, Jan; Dungl, Pavel; Horák, Martin; Štӗpán, Jan J.; Gee, Andrew H.
Abstract:
Background: Individuals with osteoporosis are predisposed to hip fracture during trips, stumbles or falls, but half of all hip fractures occur in those without generalised osteoporosis. By analysing ordinary clinical CT scans using a novel cortical thickness mapping technique, we discovered patches of markedly thinner bone at fracture-prone regions in the femurs of women with acute hip fracture compared with controls.; Methods: We analysed CT scans from 75 female volunteers with acute fracture and 75 age- and sex-matched controls. We classified the fracture location as femoral neck or trochanteric before creating bone thickness maps of the outer â corticalâ shell of the intact contra-lateral hip. After registration of each bone to an average femur shape and statistical parametric mapping, we were able to visualise and quantify statistically significant foci of thinner cortical bone associated with each fracture type, assuming good symmetry of bone structure between the intact and fractured hip. The technique allowed us to pinpoint systematic differences and display the results on a 3D average femur shape model.; Findings: The cortex was generally thinner in femoral neck fracture cases than controls. More striking were several discrete patches of statistically significant thinner bone of up to 30%, which coincided with common sites of fracture initiation (femoral neck or trochanteric).; Interpretation: Femoral neck fracture patients had a thumbnail-sized patch of focal osteoporosis at the upper head-neck junction. This region coincided with a weak part of the femur, prone to both spontaneous â tensileâ fractures of the femoral neck, and as a site of crack initiation when falling sideways. Current hip fracture prevention strategies are based on case finding: they involve clinical risk factor estimation to determine the need for single-plane bone density measurement within a standard region of interest (ROI) of the femoral neck. The precise sites of focal osteoporosis that we have identified are overlooked by current 2D bone densitometry methods.
Editors:
Shi, Xing-Ming
Citation:
PLoS One. 2012 Jun 11; 7(6):e38466
Issue Date:
11-Jun-2012
URI:
http://hdl.handle.net/10675.2/797
DOI:
10.1371/journal.pone.0038466
PubMed ID:
22701648
PubMed Central ID:
PMC3372523
Type:
Article
ISSN:
1932-6203
Appears in Collections:
Department of Pathology: Faculty Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorPoole, Kenneth E.S.en_US
dc.contributor.authorTreece, Graham M.en_US
dc.contributor.authorMayhew, Paul M.en_US
dc.contributor.authorVaculí­k, Janen_US
dc.contributor.authorDungl, Pavelen_US
dc.contributor.authorHorák, Martinen_US
dc.contributor.authorŠtӗpán, Jan J.en_US
dc.contributor.authorGee, Andrew H.en_US
dc.contributor.editorShi, Xing-Ming-
dc.date.accessioned2012-10-26T20:30:45Z-
dc.date.available2012-10-26T20:30:45Z-
dc.date.issued2012-06-11en_US
dc.identifier.citationPLoS One. 2012 Jun 11; 7(6):e38466en_US
dc.identifier.issn1932-6203en_US
dc.identifier.pmid22701648en_US
dc.identifier.doi10.1371/journal.pone.0038466en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/797-
dc.description.abstractBackground: Individuals with osteoporosis are predisposed to hip fracture during trips, stumbles or falls, but half of all hip fractures occur in those without generalised osteoporosis. By analysing ordinary clinical CT scans using a novel cortical thickness mapping technique, we discovered patches of markedly thinner bone at fracture-prone regions in the femurs of women with acute hip fracture compared with controls.en_US
dc.description.abstractMethods: We analysed CT scans from 75 female volunteers with acute fracture and 75 age- and sex-matched controls. We classified the fracture location as femoral neck or trochanteric before creating bone thickness maps of the outer â corticalâ shell of the intact contra-lateral hip. After registration of each bone to an average femur shape and statistical parametric mapping, we were able to visualise and quantify statistically significant foci of thinner cortical bone associated with each fracture type, assuming good symmetry of bone structure between the intact and fractured hip. The technique allowed us to pinpoint systematic differences and display the results on a 3D average femur shape model.en_US
dc.description.abstractFindings: The cortex was generally thinner in femoral neck fracture cases than controls. More striking were several discrete patches of statistically significant thinner bone of up to 30%, which coincided with common sites of fracture initiation (femoral neck or trochanteric).en_US
dc.description.abstractInterpretation: Femoral neck fracture patients had a thumbnail-sized patch of focal osteoporosis at the upper head-neck junction. This region coincided with a weak part of the femur, prone to both spontaneous â tensileâ fractures of the femoral neck, and as a site of crack initiation when falling sideways. Current hip fracture prevention strategies are based on case finding: they involve clinical risk factor estimation to determine the need for single-plane bone density measurement within a standard region of interest (ROI) of the femoral neck. The precise sites of focal osteoporosis that we have identified are overlooked by current 2D bone densitometry methods.en_US
dc.rightsPoole et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.subjectResearch Articleen_US
dc.subjectBiologyen_US
dc.subjectAnatomy and Physiologyen_US
dc.subjectMusculoskeletal Systemen_US
dc.subjectBiomechanicsen_US
dc.subjectBone and Joint Mechanicsen_US
dc.subjectBiochemistryen_US
dc.subjectMetabolismen_US
dc.subjectBone and Mineral Metabolismen_US
dc.subjectMedicineen_US
dc.subjectAnatomy and Physiologyen_US
dc.subjectMusculoskeletal Systemen_US
dc.subjectBoneen_US
dc.subjectRheumatologyen_US
dc.subjectBone and Mineral Metabolismen_US
dc.subjectWomen's Healthen_US
dc.subjectOsteopenia and Osteoporosisen_US
dc.titleCortical Thickness Mapping to Identify Focal Osteoporosis in Patients with Hip Fractureen_US
dc.typeArticleen_US
dc.identifier.pmcidPMC3372523en_US
dc.contributor.corporatenameDepartment of Pathology-

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