The Correlation Between Femoral Cortical Bone Thickness And Gray Value Under DR And Hip Fracture In Postmenopausal Women

BACKGROUND: The development of social economy and the improvement of living standard have increased the average age of the people.China has entered an aging society,and the treatment and prevention of brittle fracture disease have been paid more and more attention in clinic.The current internationally accepted methods for diagnosing osteoporosis and evaluating osteoporotic fractures are dual-energy X-ray absorptiometry(DXA)bone density measurements and the World Health Organization-recommended 10-year fracture risk assessment tool(FRAX).Clinically,DXA measurements of bone density and the use of FRAX alone have been found to be limited in the diagnosis of brittle fractures and in the assessment of fracture risk,for example,DXA does not reflect bone quality factors in bone strength,and FRAX underestimates the actual risk of brittle fractures.At present,cortical bone thickness,as one of the new methods to evaluate the risk of brittle fracture,has become one of the hot spots in the research on the risk of brittle fracture,especially in the research on measurement methods and the influence of alveolar implants.OBJECTIVE: To investigate the correlation between cortical thickness and X-ray gray value of different planes of proximal femur and brittle fracture of the hip in women aged 50 years under DR photography,so as to explore the correlation between different planes of proximal femur and brittle fracture of the hip in women aged 50 years.METHODS: Clinical data of female patients over 50 years old who underwent DR standard orthotopic pelvic radiography in the Ninth Affiliated Hospital of Guangxi Medical University from July 2018 to December 2019 were collected.According to the inclusion and exclusion criteria,50 patients were randomly selected from women aged 50-64 and 65 years old and above as study subjects,denoted as group A and Group B in turn,with A total of 100 patients.The fracture and cortical bone thickness in the samples were observed.The measurement planes for the thickness of proximal femoral cortical bone were designed as the middle part of the femoral neck,within 1 cm above the lesser trochanter,and within 1 cm below the lesser trochanter.The measurement of X-ray gray value takes the line between the midpoint of the greater rotor and the lesser rotor as the rectangular diagonal and takes the rectangular area for measurement.RESULTS:(1)Women aged 50-64 years were as group A(n=50)and aged 65 and older were as group B(n=50).(2)The bone cortex thickness value and X-ray grayscale value of cortical thickness values within 1 cm below the lesser trochanter,and within 1 cm above the lesser trochanter in the group B were significantly lower than those in the group A(P < 0.05).There was no significant difference in the bone cortex thickness value of middle part of the femoral neck between two groups(P > 0.05).(3)On the whole,cortical thickness values were highest in the within 1 cm below the lesser trochanter,followed by within 1 cm above the lesser trochanter and lowest in the middle part of the femoral neck(P <0.05).(4)The correlation coefficient of cortical thickness and X-ray gray value of the within 1 cm below the lesser trochanter and within 1 cm above the lesser trochanter and age to brittle fracture was-0.303,-0.205,-0.272,and 0.346(P <0.05).There was no significant correlation between middle part of the femoral neck and brittle fracture(P > 0.05).(5)The difference of cortical thickness of the within 1 cm below the lesser trochanter and within 1 cm above the lesser trochanter between fracture and non-fracture groups in the group A was significant(P < 0.05).There was no significant difference in each index between fracture and non-fracture groups in the group B(P > 0.05).At the age above 50 years,the difference of cortical thickness and X-ray gray value in each measured plane between fracture and the non-fracture groups was significant(P < 0.05).CONCLUSIONS: The cortical bone thickness is thinner within 1 cm below the trochanter and within 1 cm above the trochanter,and the X-ray gray value becomes smaller,so the possibility of hip brittle fracture is higher.On DR tablets,measurements within 1 cm below the trochanter are recommended for assessing the risk of brittle fracture of the hip in women over 50 years of age using proximal femoral cortical thickness.Except that the X-ray gray value may reflect the loss of bone mass to some extent,it can not be excluded that it is a comprehensive reflection of the bone quality including cortical bone and bone microstructure.