1 362

Cited 19 times in

Detection of prefracture hip lesions in atypical subtrochanteric fracture with dual-energy x-ray absorptiometry images

 Sungjun Kim  ;  Kyu Hyun Yang  ;  Hyunsun Lim  ;  PhD  ;  Young-Kyun Lee  ;  Han Kook Yoon  ;  Chang-Wug Oh  ;  Kwan Kyu Park  ;  Byung-Woo Min  ;  Jeong Ah Ryu  ;  Kyu-Sung Kwack  ;  Young Han Lee 
 RADIOLOGY, Vol.270(2) : 487-495, 2014 
Journal Title
Issue Date
Absorptiometry, Photon* ; Aged ; Aged, 80 and over ; Early Diagnosis* ; Female ; Hip Fractures/diagnostic imaging* ; Hip Fractures/pathology ; Humans ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors
PURPOSE: To retrospectively assess how often and how early hip dual-energy x-ray absorptiometry (DXA) images show prefracture lesions in patients with atypical subtrochanteric fracture (ASF) and determine whether DXA images with assessment of prodromal symptoms could be used for early ASF prediction.
MATERIALS AND METHODS: The retrospective research protocol complied with HIPAA and was institutional review board approved, with waiver of informed consent. Among 62 women with ASF, nine without hip DXA images and seven without clear documentation of prodromal symptoms were excluded. Serial DXA images of 52 hips in 46 patients were included. Among them, 33 hips were assessed with ipsilateral DXA. For this ipsilateral group, each hip was assessed for prodromal symptoms and focal cortical changes in the lateral subtrochanteric femur cortex at DXA. Overall and cumulative detection rates for prodromal symptoms, DXA, and DXA with prodromal symptoms were measured and compared with a general linear model for overall detection rate and Cox proportional hazard models for cumulative detection rate. Thirty-three representative ipsilateral images and 199 images from subjects without fractures were reviewed in random order for prefracture lesions by three musculoskeletal radiologists independently, and the performance of DXA in ASF prediction was assessed.
RESULTS: Overall detection rates for DXA, prodromal symptoms, and DXA with prodromal symptoms were 61% (20 of 33), 42% (14 of 33), and 73% (24 of 33), respectively, in the ipsilateral group. Overall detection rate comparisons showed that DXA with prodromal symptoms was superior to prodromal symptoms alone (P = .0377). The cumulative detection rate curve for DXA with prodromal symptoms was also superior to that of prodromal symptoms alone (P = .0018). Sensitivity and specificity of DXA in ASF prediction ranged from 52% (17 of 33) to 58% (19 of 33) and 99% (197 of 199) to 100% (199 of 199), respectively.
CONCLUSION: Assessment of hip DXA images combined with conventional assessment of prodromal symptoms enables detection of more ASFs earlier than assessment based on prodromal symptoms alone.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
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.