Statistical shape modelling of hip and lumbar spine morphology and their relationship in the MRC National Survey of Health and Development

Abstract

The anatomical shape of bones and joints is important for their proper function but quantifying this, and detecting pathological variations, is difficult to do. Numerical descriptions would also enable correlations between joint shapes to be explored. Statistical shape modelling (SSM) is a method of image analysis employing pattern recognition statistics to describe and quantify such shapes from images; it uses principal components analysis to generate modes of variation describing each image in terms of a set of numerical scores after removing global size variation. We used SSM to quantify the shapes of the hip and the lumbar spine in dual‐energy x‐ray absorptiometry (DXA) images from 1511 individuals in the MRC National Survey of Health and Development at ages 60–64 years. We compared shapes of both joints in men and women and hypothesised that hip and spine shape would be strongly correlated. We also investigated associations with height, weight, body mass index (BMI) and local (hip or lumber spine) bone mineral density. In the hip, all except one of the first 10 modes differed between men and women. Men had a wider femoral neck, smaller neck‐shaft angle, increased presence of osteophytes and a loss of the femoral head/neck curvature compared with women. Women presented with a flattening of the femoral head and greater acetabular coverage of the femoral head. Greater weight was associated with a shorter, wider femoral neck and larger greater and lesser trochanters. Taller height was accompanied by a flattening of the curve between superior head and neck and a larger lesser trochanter. Four of the first eight modes describing lumbar spine shape differed between men and women. Women tended to have a more lordotic spine than men with relatively smaller but caudally increasing anterior‐posterior (a‐p) vertebral diameters. Men were more likely to have a straighter spine with larger vertebral a‐p diameters relative to vertebral height than women, increasing cranially. A weak correlation was found between body weight and a‐p vertebral diameter. No correlations were found between shape modes and height in men, whereas in women there was a weak positive correlation between height and evenness of spinal curvature. Linear relationships between hip and spine shapes were weak and inconsistent in both sexes, thereby offering little support for our hypothesis.In conclusion, men and women entering their seventh decade have small but statistically significant differences in the shapes of their hips and their spines. Associations with height, weight, BMI and BMD are small and correspond to subtle variations whose anatomical significance is not yet clear. Correlations between hip and spine shapes are small.

Age at Onset of Walking in Infancy Is Associated With Hip Shape in Early Old Age

“…Although osteoporosis was prevalent at other sites in this cohort, there was no evidence of hip osteoporosis in individuals included in this study (minimum Z ‐score −2.4) and few fractures; therefore, associations between walking age, hip shape, and fractures could not be explored. There was no effect of adjustment for hip BMD on associations between walking age and hip shape, although only weak associations between hip BMD and hip mode scores in this cohort have been reported . In addition, previous studies have shown that hip shape modes are predictive of hip fracture independent of BMD .…”

“…Three images were excluded because of extreme internal rotation of the femur, evidenced by femoral neck foreshortening, leaving 1633 images to build the hip SSM. SSM of hip images in this cohort has been described in detail previously . Briefly, a template of 68 points for the hip was placed around the area of interest in each image using Shape software (University of Aberdeen, Scotland).…”

“…Ten modes were identified; each accounted for >2% hip shape variation. In total, these modes accounted for 80.6% of the total variance …”

“…Potential confounders and mediators of the main associations between walking age and each hip mode were selected a priori based on existing literature . The potential confounders were birthweight, childhood socioeconomic position (SEP), adult SEP, and height, and the potential mediators were appendicular lean mass and appendicular fat mass.…”

“…Furthermore, SSM has clinical utility in predicting hip OA progression and in improving prospective prediction of hip fracture when combined with BMD measurements . With relevance to skeletal loading, recent work using SSM found associations between BMI at different stages of adulthood and hip shape in older men and women …”