Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Reliability of the Radiologic Measurement Methods for Assessment of Osteoporosis Using the Digital Hip Radiograph

고관절 디지털 방사선을 이용하여 측정한 방사선적 골다공증 측정 방법들의 유용성

  • Yun, Ho-Hyun (Department of Orthopedic Surgery, Seoul Veterans Hospital) ;
  • Yi, Ju-Won (Department of Orthopedic Surgery, College of Medicine, Ewha Womans University) ;
  • Lim, Deuk-Soo (Department of Orthopedic Surgery, Seoul Veterans Hospital) ;
  • Park, Sung-Chul (Department of Orthopedic Surgery, Seoul Veterans Hospital) ;
  • Oh, Seong-Rok (Department of Orthopedic Surgery, Seoul Veterans Hospital)
  • 윤호현 (서울보훈병원 정형외과) ;
  • 이주원 (이화여자대학교 의과대학 정형외과학교실) ;
  • 임득수 (서울보훈병원 정형외과) ;
  • 박성철 (서울보훈병원 정형외과) ;
  • 오성록 (서울보훈병원 정형외과)
  • Published : 2011.06.30
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Abstract

Purpose: We evaluated the usefulness of radiographic parameters for osteoporosis by analyzing the results of radiographic parameters determined by digital hip radiographs and bone mineral density T-scores, as assessed by Dual Energy X-ray Absorptiometry (DEXA). Materials and Methods: The authors reviewed 100 subjects in the hip fracture group and 50 in the non-fracture control group. Digital hip radiographs were assessed to determine the values of Singh index, Canal-to-Calcar Ratio, and Cortical Thickness Index (CTI). Bone mineral density was assessed by DEXA. Results: Intraclass Correlation Coefficient (ICC) results of the CTI were above 0.8 in the fracture group. Compared to the control group, the fracture group showed higher ICCs. Interobserver ICCs were especially lower in the control group. There were statistically significant correlations between CTI and DEXA (r=0.50~0.58, p<0.05). In the analysis of ROC curves, a mean threshold for CTI set a value of 0.54 (0.53~0.55), and mean sensitivity and specificity were 75.5% (69~79%) and 67.8% (65~78%), respectively. Conclusion: CTI showed reasonable reliability and correlation with DEXA results. CTI was a useful radiographic parameter to alert the surgeon to recommend referral for osteoporosis evaluation in elderly hip fracture patients.

목적: 디지털 방사선 영상을 이용하여 방사선적 골다공증 지표들을 측정하고 방사선적 골다공증 지표들의 유용성을 알아보고자 하였다. 대상 및 방법: 고관절 주위골절로 진단 받았던 65세 이상의 환자 100 명을 골절 군으로 설정하고 65세 미만의 비 골절 50명을 대조 군으로 설정하였다. Singh Index, Canal-to-Calcar Ratio, Cortical Thickness Index (CTI)를 측정하였으며 골밀도 측정을 위해서 이중 에너지 방사선 (DEXA) 골밀도 검사를 시행하였다. 결과: CTI 측정 결과들에 대한 관찰자 내 및 관찰자간 Intraclass Correlation Coefficient (ICC) 결과상 골절 군에서는 ICC 값이 모두 0.8 이상으로 대조 군과 비교 시 골절 군에서 모두 높았으며 대조 군에서는 특히 관찰자간 ICC 값이 상대적으로 낮았다. CTI와 DEXA 골밀도 검사결과들간에는 통계적으로 유의한 상관관계가 관찰되었다(r=0.50~0.58, p<0.05). 결론: CTI가 만족스러운 신뢰도를 보이며 DEXA 골밀도 검사와의 연관성을 보여서 특히 노령의 고관절 주위 골절 환자들에서 골다공증을 진단하고 치료하기 위한 노력을 유도하는데 유용하다고 판단된다.

Keywords

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