Calcaneal bone density as a screening tool for osteoporosis

Author(s): Dr. Sharath Kumar P V and Akash Hosthota

Abstract: Introduction: Osteoporosis is a common disease in elderly associated with high morbidity and economic burden. Low bone mass is the strongest predictor of low and moderate energy fracture risk. As there are accurate as well as safe diagnostic tests available and treatment is effective, early diagnosis and quantification of bone loss and fracture risk have become more important so that it can slow or even reverse the progression of osteoporosis. Material and Methods: This is a prospective study, conducted on patients with intertrochantric and neck of femur fractures in the age group of 50 to 75 years. The period of study is 6 months from May 2017 to October 2017. 96 Patients (34 neck of femur and 62 intertrochantric fractures) were selected into the study from those presenting to Victoria hospital and Bowring hospital, Bangalore medical college and research institute, Bangalore. The calcaneal X ray of the uninjured limb was taken along with the X ray of pelvis with both hip joint. The films were then scored based on the trabecular pattern by 2 different observers and recorded in separate charts. After a minimum of 2 weeks, the same observers scored the radiographs again for assessment of intra-observer reproducibility. Calcaneal index score and Singhs index scores were compared. Results: As the age progressed there is a linear relationship in the bone density and the calcaneal index scored. However there is some discrepancy in the score of Singhs index and Calcaneal index. But this difference is not a statistically significant. Conclusion: Calcaneal index can be used as a screening tool for diagnosing osteoporosis, it is cost effective, requires less radiation dose exposure and the radiation directed away from the gonads, even though it does not predict the exact bone density.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4g.67