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Significance of single hip versus bilateral hip measurements of bone mineral density

¹ Nuclear Medicine, Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York

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Objectives: Dual-energy x-ray absorptiometry (DXA) is the "gold standard" technique for measuring bone mineral density (BMD). The International Society for Clinical Densitometry (ISCD) recommends scanning the lumbar spine and either hip. A single study showed significant left-right differences in BMD [1].

Methods: DXA scans of 150 consecutive patients (21 to 92 years), including 11 (7.3%) males, 12 (8%) pre-menopausal women, and 127 (84.7 %) menopausal women, were reviewed. Scanning was performed on a GE Lunar scanner. Final diagnosis was made per WHO criteria and ISCD recommendations [2]. Significant difference between total right hip (TRH) and total left hip (TLH), as well as between right femoral neck (RFN) and left femoral neck (LFN), was calculated using signed ranks test.

Results: The BMD was overall normal in 43 patients (28.7%), osteopenia was present in 81 (54%), and osteoporosis in 26 (17.3%). The mean difference of BMD between TLH and TRH was -0.34% (ranging between -13.7% and 21.1%, overall right lower than left), which was not significant (p=0.54). In 134 patients (89%), there was equal classification of BMD for TRH or TLH, demonstrating no significant difference (p=0.98). Using FN measurements, the BMD classification was the same for either side in 121 patients (81%) (p=0.35).

Conclusions: There is no significant difference in BMD measurements between right and left hip or femoral neck. There is no added clinical benefit in the measurement of BMD in both hips as against single hip measurement.

Research Support: 1. Hamdy R et al. The prevalence of significant left-right differences in hip bone mineral density. Osteoporos Int. 2006(12):1772-80. 2. ISCD, Official Positions of the International Society for Clinical Densitometry, updated 2005:2-11.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Lebron, L. Articles by Strauss, H. W. PubMed Articles by Lebron, L. Articles by Strauss, H. W.