Cortical Bone Defects Associated with Hip Fractures in Men
Bone Biomechanics and Quality (Clinical)
Osteoporosis - Assessment
Poster Sessions, Presentation Number: LB-SU25
Session: Late-Breaking Posters II
Sunday, October 6, 2013 12:00 PM - 2:00 PM, Baltimore Convention Center, Discovery Hall-Hall C
* , UNITED STATES, , UNITED KINGDOM, Andrew Gee, University of Cambridge, Karen Blesic, University of Cambridge, Madhavi Vindlacheruvu, Cambridge University Hospitals NHS Foundation Trust, Simon Donell, Norfolk and Norwich University Hospital NHS Foundation Trust, , UNITED KINGDOM
Background: Studies have shown that women who sustain hip fracture have a structural phenotype. Quantitative computed tomography (QCT) measurements of cortical bone in conventional regions of interest (ROI’s) are associated with hip fracture in both men and women, especially cortical thinning superiorly in the femoral neck. Therefore, we aimed to study if a phenotype could be identified among male hip fracture cases, using cortical bone mapping.
Design, Setting and Participants: Participants in this case-control study included 20 British men (mean age 79yr, SD: 8) with a hip fracture and 24 British healthy controls (mean age 69yr, SD: 10). The cortical bone mapping technique was applied to clinical CT scans to identify locations where cortical bone in hip fracture cases differed, on average, from controls. This method involves non-rigid registration to an average femur surface and statistical parametric mapping to identify ROI’s where clusters of values differ significantly, using Stradwin and Surfstat software. For cases, the non-fractured hip was used. Model effects were group (case*control), age, weight, height, and shape. The results are presented as percentage differences in cortical bone mass between cases and controls with a scaled colour map on an average femur model.
Results: Figure 1 displays the locations of significant (p<0.05) cortical bone mass differences associated with hip fracture; in the supero-lateral and inferior aspects of the femoral neck and lateral trochanteric region (red/yellow regions).
Conclusion: Percentage differences in cortical mass were greatest superiorly in the femoral neck, with cases up to 40% lower in a patch where fractures may initiate. These patches in male hip fracture cases are similar to those found in women using voxel-based-morphometry, where there was loss of bone both at the superior cortex and the inferior cortex (Carballido-Gamio J Bone Miner Res 2013). These results indicate that women and men who sustain hip fracture might have a similar structural phenotype. This suggests that the mechanism causing cortical bone loss in ‘at risk’ individuals appears to be the same in men and women.
K. Poole, Has a patent relating to the cortical image analysis techniques: Other. G. Treece, Has a patent relating to the cortical image analysis techniques: Other.
* Presenting Authors(s):
, UNITED STATES