Michael B. Gerhardt, MD, an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, comments by email, “Previous bone density tests were performed using a DEXA scan, which can generically show if someone’s hip has diminished bone density.”
“However,” he tells Reuters Health, “this study uses a specialized CT scan mapping system that can not only identify a hip with diminished bone density but can accurately map which parts of the hip bone are affected. This technology may allow us to more accurately identify patients who are at risk for hip fracture and therefore more aggressively engage that patient in hip fracture prevention strategies.”
“The biggest downside is that CT scans expose patients to ionizing radiation,” says Dr. Gerhard, who was not involved in the study. “Although the exposure is fairly low, there is a theoretical risk of the radiation putting the patient at higher risk of developing a tumor in the future. While the risk is low, in an elderly patient it is not negligible.”
“The findings could have ‘real-world’ implications in two major ways,” he notes. “The first is in changing the paradigm of how we currently screen for bone density deficits. Based on the results of this study it would seem reasonable to change (from bone densitometry) to a CT-based technology.”
“The CT scan-based screening could not only tell us who has bone density deficits in the hip, but can specifically map the bone density and tell us which parts of the hip are specifically lacking in density,” he says.
“For example, if the bone weakness occurs in the trochenteric region, then certain abductor strengthening exercises may be more important for hip fracture prevention than what we previously recommended, which was simple weight bearing exercise such as walking,” he explains. “We could target our prevention strategies specifically on the part of the hip that is most afflicted.”
“Hopefully, this will lead to fewer hip fractures in our elderly population,” Dr. Gerhard concludes.
Reference
- Marques EA, Carballido-Gamio J, Gudnason V, et al. Sex differences in the spatial distribution of bone in relation to incident hip fracture: Findings from the AGES-Reykjavik study. Bone. 2018 May 16. pii: S8756-3282(18)30204-7. doi: 10.1016/j.bone.2018.05.016. [Epub ahead of print]
