Comparison and investigation of bone mineral density in opposing femora by dual-energy X-ray absorptiometry

Abstract

A dual-energy X-ray absorptiometry (DXA) machine was used to measure the bone mineral density (BMD) of both femora in 760 female volunteers. Each volunteer completed a questionnaire and exclusion criteria were applied such that only 480 of these were considered normal subjects. The remaining 280 women failed to comply with the criteria and were considered 'abnormal'; their BMD results were analysed separately. Two abnormal subgroups, one with previous long bone fractures and one with radiologically diagnosed osteopenia, were studied. BMD values for femoral neck, Ward's triangle and trochanter were compared between the two femora in all the above groups. No dominance relationship was found when comparing left to right femur, averaged over any population studied, but large differences were found between the femora in individual volunteers. There was a high correlation between BMD in opposing femora of 0.91, 0.91 and 0.84 for the femoral neck, Ward's triangle and trochanter respectively. However, in normal subjects the percentage variation in these regions ranged up to 34%, 64% and 80% respectively at the different femoral sites. In addition, the normal population was divided into two subgroups, one in which the density difference between the femora was large, and the other in which the difference was statistically insignificant. The analytical and anatomical variations between these two groups were investigated. Only part of the difference appeared to be due to analytical problems and it seems that there is a genuine difference in femoral density. Poor correlation for femoral neck percentage density difference was found with average BMD, age, height and weight in the normal population.(ABSTRACT TRUNCATED AT 250 WORDS)

The Influence of Physical Activity and Fractures on Ultrasound Parameters in Elderly People

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“…The difference in BMD between contralateral bones has been the subject of investigation before, and it has been suggested that routine BMD measurements at the hip should include both sides [25]. In this study substantial differences in calcaneal ultrasound parameters between the left and the right side were measured.…”

Measurement of Bone Adjacent to Tibial Shaft Fracture

“…Values from the non-fractured limb were used as a control for measurements. Previous studies have shown that there is no effect of lower limb dominance on DXA BMD and velocity of sound (VOS) in a normal population [20,27,28]. However, broadband ultrasound attenuation (BUA) has previously shown a difference, but this could be as a consequence of the artifact of the measurement rather than any true difference in the bone [29].…”

Scanning both Hips and the Lumbar Vertebrae in Men Identifies More Patients with Osteoporosis than Scanning One Hip and the Lumbar Vertebrae

“…Arguments for scanning both hips include the differences between the left and right T-scores observed in some patients who may result in the patient being classified differently if one or both hips are scanned [1][2][3][4][5], and being able to follow up patients who fracture one hip or undergo hip replacement. Arguments against scanning both hips include the good correlation that exists between the BMD of both hips [6][7][8][9][10][11], unnecessary exposure to radiation and the time taken to perform the scan. On the other hand, exposure to radiation is now so small as to be negligible, and the time factor is no longer an issue with modern densitometers, many offer the ability of scanning both hips without repositioning the patient.…”