Differences in Bone Mineral Density between the Right and Left Hips in Postmenopausal Women

다국어 초록 (Multilingual Abstract)

Bone mineral density (BMD) using dual energy radiography absorptiometry are commonly used for the diagnosis of osteoporosis. It is usually measured at the spine and also at one hip joint. Controversy still exists regarding the use of bilateral hip scanning. We analyzed the difference of BMD at bilateral hips in 384 postmenopausal women, retrospectively. The concordance and discordance rates of the lowest T-score and BMD between both hips were evaluated. The BMDs of the femoral neck and trochanter were significantly different between both hips (P < 0.05). There were also discrepancies between the lowest T-scores of both hips (P < 0.05). The discordance rates were about 30%. Due to significant differences in BMD between both hips at the femoral neck and trochanter and high discordance rate, bilateral hip measurements using DEXA are recommended to avoid underestimating osteoporosis.

참고문헌 (Reference)

1 Hall ML, "Variation between femurs as measured by dual energy X-ray absorptiometry (DEXA)" 18 : 38-40, 1991

2 Lessig HJ, "The symmetry of hip bone mineral density. A dual photon absorptiometry approach" 12 : 811-812, 1987

3 Hamdy R, "The prevalence of significant left-right differences in hip bone mineral density" 17 : 1772-1780, 2006

4 Wong JC, "The diagnostic role of dual femur bone density measurement in low-impact fractures" 14 : 339-344, 2003

5 Yang RS, "Symmetry of bone mineral density in the hips is not affected by age" 17 : 711-716, 1996

6 Goh SK, "Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution" 89 : 349-353, 2007

7 Krahl H, "Stimulation of bone growth through sports. A radiologic investigation of the upper extremities in professional tennis players" 22 : 751-757, 1994

8 Black DM, "Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group" 348 : 1535-1541, 1996

9 김상림, "Orthopedic Surgeon’s Awareness Can Improve Osteoporosis Treatment Following Hip Fracture: A Prospective Cohort Study" 대한의학회 26 (26): 1501-1507, 2011

10 Prince RL, "Forearm bone loss in hemiplegia: a model for the study of immobilization osteoporosis" 3 : 305-310, 1988

11 Brownbill RA, "Dual hip bone mineral density in postmenopausal women: geometry and effect of physical activity" 73 : 217-224, 2003

12 Gotfredsen A, "Does a single local absorptiometric bone measurement indicate the overall skeletal status? Implications for osteoporosis and osteoarthritis of the hip" 9 : 193-203, 1990

13 이동윤, "Determination of an Applicable FRAX Model in Korean Women" 대한의학회 25 (25): 1657-1660, 2010

14 Balseiro J, "Comparison of bone mineral density in both hips" 167 : 151-153, 1988

15 Lilley J, "Comparison and investigation of bone mineral density in opposing femora by dual-energy X-ray absorptiometry" 2 : 274-278, 1992

16 Hamdy RC, "Changes in bone mineral content and density after stroke" 72 : 188-191, 1993

17 Franck H, "Bone mineral density of opposing hips using dual energy X-Ray absorptiometry in single-beam and fan-beam design" 61 : 445-447, 1997

18 Mazess RB, "Bilateral measurement of femoral bone mineral density" 3 : 133-140, 2000

19 Capeci CM, "Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy" 91 : 2556-2561, 2009

20 Puhaindran ME, "Atypical subtrochanteric femoral fractures in patients with skeletal malignant involvement treated with intravenous bisphosphonates" 93 : 1235-1242, 2011

21 WHO Study Group, "Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group" 843 : 1-129, 1994

22 Kanis JA, "Assessment of fracture risk" 16 : 581-589, 2005

23 Petley GW, "An investigation of the diagnostic value of bilateral femoral neck bone mineral density measurements" 11 : 675-679, 2000

24 Takamoto S, "Alterations of bone mineral density of the femurs in hemiplegia" 56 : 259-262, 1995

25 Kanis JA, "A meta-analysis of prior corticosteroid use and fracture risk" 19 : 893-899, 2004

26 Kanis JA, "A family history of fracture and fracture risk: a meta-analysis" 35 : 1029-1037, 2004