0 267

Cited 4 times in

Lateral Cortical Thickening and Bone Heterogeneity of the Subtrochanteric Femur Measured With Quantitative CT as Indicators for Early Detection of Atypical Femoral Fractures in Long-Term Bisphosphonate Users

 Seung Hyun Lee  ;  Young Han Lee  ;  Jin-Suck Suh 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.209(4) : 867-873, 2017 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Bone Density ; Bone Density Conservation Agents/adverse effects* ; Diphosphonates/adverse effects* ; Early Diagnosis ; Female ; Femoral Fractures/chemically induced* ; Femoral Fractures/diagnostic imaging* ; Femur/diagnostic imaging* ; Femur/pathology* ; Humans ; Middle Aged ; Retrospective Studies ; Time Factors ; Tomography, X-Ray Computed*
atypical femoral fracture ; bisphosphonate ; bone mineral density ; osteoporosis ; quantitative CT (QCT)
OBJECTIVE: The objective of our study was to compare subtrochanteric femur bone mineral density (BMD) and bone quality of long-term bisphosphonate (BP) users who sustained an atypical femoral fracture (AFF) with BP users who did not sustain a femoral fracture and BP-naïve patients with no history of femoral fracture using quantitative CT (QCT).

MATERIALS AND METHODS: Fourteen female BP users with an AFF (mean age, 72.6 years; mean duration of BP use, 6.2 years; mean body mass index, 21.9) who had undergone QCT before fracture events were sex-, age-, BP use duration-, and body mass index-matched to 14 BP users who did not sustain a fracture and 14 BP-naïve patients. The lateral cortical thickness index (CTI) and the mean BMD (BMDmean) and SD of the BMD (BMDSD) within the lateral cortex and within the entire cross-sectional area of the subtrochanteric femur were measured on axial QCT. Femoral neck-shaft angles were measured on the QCT scout image. Parameters were analyzed using the Kruskal-Wallis test.

RESULTS: Lateral CTIs were greater in the BP users with an AFF (median, 0.28) than in the BP users without a femoral fracture (median, 0.21) (p = 0.038) and the BP-naïve group (median, 0.21) (p = 0.009). The lateral cortex BMDSD was significantly higher in the BP users with an AFF (median, 59.59 mg/cm3) than the BP users without a femoral fracture (median, 39.27 mg/cm3; p = 0.049) and the BP-naïve group (median, 31.02 mg/cm3; p = 0.037). There was no significant difference among groups in lateral cortex BMDmean, BMDmean and BMDSD of the entire cross-sectional area, and femoral neck-shaft angle.

CONCLUSION: Long-term BP users with a subsequent AFF had a thicker lateral cortex and higher lateral cortex BMDSD at the subtrochanteric area before the fracture on QCT than BP users who did not sustain a femoral fracture and BP-naïve patients.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Lee, Seung Hyun(이승현)
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.