Around the world, there are 1.7 million hip fractures annually, mostly in older people as well as women with osteoporosis. Hip fractures can be hazardous, especially for elders, because it often requires intense rehabilitation and results in seniors who cannot lead an independent life.
Also, between 20 and 30 percent of these patients die from complications. Hip fractures demand a great amount of care and result in heavy costs to the healthcare services, in addition to being painful for the patients. In fact, a previous study reports that costs of fractures fragility in the European Union account for around 55 percent of all costs.
Principal investigator, Associate Professor Torkel Brismar of Karolinska Institutet's Department of Clinical Sciences, Intervention and Technology, says:
"If we can identify people with osteoporosis and treat them with drugs, we can reduce the risk of hip fracture. Our research shows that DXR is a technique that lends itself well to this, maybe at general health check-ups, or screenings, for example, or when people seek treatment for a suspected hand or wrist fracture."
During the current study, the research team assessed digital hand X-rays take at three separate hospitals in Stockholm, Sweden between 2000 and 2008. Their data consisted of pictures from 8,000 men and women aged 40 or older. They linked bone density in the hand to risk of hip fracture by using DXR and by looking in the National Board of Health and Welfare fracture registry.
Examination of a sub-group of 122 patients who underwent a post X-ray hip fracture, revealed that they had notably lower bone density than those who had not had a hip fracture; when adjusted for age, it showed the same result.
DRX uses a regular X-ray of the hand to examine the thickness and texture of the metacarpal bones. The automatic analysis consists of about 1,000 measurements. The normal procedure for measuring bone density is DXA (dual-energy ray absorbtiometry).
In the current study, investigators showed that DXR is at least as successful as DXA, meaning that the former could be an important feature of osteoporosis examinations in the future (in addition to a general screening).
Many first time projects are starting in several countries to determine whether DXR screening of bone density is a helpful way of preventing hip fractures.