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DETERMINING OSTEOPOROSIS FROM RADIOGRAPHS AFTER WRIST FRACTURES

Department of Orthopaedics, Royal United Hospital, Combe Park, Bath BA1 3NG

Osteoporosis is an increasing problem due to increasing age and inactivity. Distal radial fractures are often the first symptom of this disease. Medical treatment can reduce the risk of further fractures (including hip fractures with the associated mortality and morbidity).

To develop a method for accurate assessment of bone density from routine wrist radiographs:

1. Various bone substitutes were tested until one was found that gave reasonable density matches with fresh bone over a limited X-ray kV range;
   
2. Twenty patients with distal radius fractures had the bone substitute placed beside the wrist being X-rayed.
   

Wrist and radius thickness were measured from the radiograph. This was combined with the optical density of the distal radius (relative to the bone substitute) to calculate a value for the bone density. The patients subsequently underwent a DEXA scan of the contralateral (uninjured) wrist. [The X-ray calculated bone density and the DEXA density compare well. (R>0.5]

Conclusion: This technique gives reasonably accurate results. It is not yet ready for clinical practice. A larger study is required to improve the accuracy of this technique, perhaps comparing results with lumbar spine DEXA.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom