Article

Prediction of hip fractures from pelvic radiographs: The study of osteoporotic fractures

  1. Claus-C. Glüer Ph.D.1,*,
  2. Steven R. Cummings2,3,
  3. Alice Pressman2,
  4. Jiao Li1,
  5. Kathrin Glüer1,
  6. Kenneth G. Faulkner1,
  7. Stephan Grampp1,
  8. Harry K. Genant1

Article first published online: 3 DEC 2009

DOI: 10.1002/jbmr.5650090512

Issue

Journal of Bone and Mineral Research

Journal of Bone and Mineral Research

Volume 9, Issue 5, pages 671–677, May 1994

Additional Information

How to Cite

Glüer, C.-C., Cummings, S. R., Pressman, A., Li, J., Glüer, K., Faulkner, K. G., Grampp, S. and Genant, H. K. (1994), Prediction of hip fractures from pelvic radiographs: The study of osteoporotic fractures. J Bone Miner Res, 9: 671–677. doi: 10.1002/jbmr.5650090512

Author Information

  1. 1

    Department of Radiology, University of California, San Francisco, San Francisco, California

  2. 2

    Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California

  3. 3

    Division of General Internal Medicine, University of California, San Francisco, San Francisco, California

*Department of Radiology University of California, San Francisco Box 0628 San Francisco, CA 94143

Publication History

  1. Issue published online: 3 DEC 2009
  2. Article first published online: 3 DEC 2009
  3. Manuscript Accepted: 20 SEP 1993
  4. Manuscript Revised: 26 AUG 1993
  5. Manuscript Received: 9 MAR 1993

Funded by

  • U.S. Public Health Service. Grant Numbers: 1-ROI-AG05407, 1-ROI-AR35582, 5-ROI-AG 05394, 1-ROI-AM35584, 1-ROI-AR35583

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Abstract

To determine whether simple measurements made on conventional radiographs of the hip could predict hip fractures, we obtained pelvic radiographs on 9704 white women age 65 or older. We analyzed the radiographs of all 162 women who subsequently suffered a hip fracture and 162 randomly selected women who did not. Adjusting for age, four measurements independently predicted hip fracture: reduced thickness of the femoral shaft cortex (odds ratio 1.7 per standard deviation; 95% confidence interval 1.2, 2.3) and of the femoral neck cortex (1.4 per standard deviation; 1.0, 1.9), reduction in an index of tensile trabeculae (2.0 per unit; 1.4, 2.9), and wider trochanteric region (1.4 per standard deviation; 1.0, 2.0). The combination of these four measurements predicted hip fracture at least as strongly as did measurement of bone density of the femoral neck (areas of the receiver-operating characteristic curve = 0.81 and 0.80, respectively). We conclude that simple measurements made on pelvic radiographs predict hip fractures as well as bone density of the hip.

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