Feasibility of diagnosing osteoporosis using routine computed tomography scans for hip fractures: Correlation with histopathological diagnosis of head and neck regions

Objective: The aim of this study was to demonstrate the feasibility of diagnosing osteoporosis through routine computed tomography (CT) by assessing the association between the histopathological assessment of femoral head specimens extracted from patients who underwent surgery for intertrochanteric fractures and the Hounsfield unit (HU) measurements derived from preoperative CT scans.

Methods: Forty-eight patients who presented to our clinic between November 2019 and May 2020 with hip fractures and underwent partial prosthesis fixation were included in this retrospective study. Hounsfield unit measurements were performed on the head and neck regions using dual-energy x-ray absorptiometry (DEXA) and CT scans, respectively. The trabecular ratio per unit area was calculated using the Nikon Imaging Software (NIS-Elements ) program in the pathology laboratory from digitally captured images of the removed head and neck specimens.

Results: The mean HU receiver operating characteristic analysis had a sensitivity of 77% and a specificity of 87%, with a cutoff value of 77.68. There was a moderate correlation between the mean trabecular density and the mean HU of the femoral head (P=0.013, r=0.340). Additionally, there was a significant correlation between the mean HU and the T-score of the head, although this correlation was not found with the maximum–minimum HU. Although there was a significant correlation between trabecular density and mean HU, the correlation coefficient indicated a moderate relationship. This relationship was also observed between the inferior sections of the head and the trabecular density and HU (P=.018). However, no significant correlation was found between the T-score and the trabecular structure of the head (P=.977).

Conclusion: The results of the present study suggest that conventional CT has the potential to serve as a diagnostic tool for osteoporosis and may offer a more precise and accurate method for evaluating the success of intraosseous implants when compared to T-scores without the need for additional tests or procedures.

Cite this article as: Imren Y, Karslioglu B, Dedeoglu SS, Keskin A, Berkay AF, Tekin AC. Feasibility of diagnosing osteoporosis using routine computed tomography scans for hip fractures: Correlation with histopathological diagnosis of head and neck regions. Acta Orthop Traumatol Turc., 2023;57(6):384-388.