Dual energy x-ray absorptiometry analysis contributes to the prediction of hip osteoarthritis progression

Abstract

IntroductionTo determine if structural bone parameters obtained from dual energy X-ray absorptiometry (DXA) contribute to the prediction of progression of hip osteoarthritis (OA) and to test if the difference between the most affected (OA) hip and the contralateral hip adds to this prediction.MethodsThe study group involves a prospective cohort of 189 patients that met the American College of Rheumatology (ARC) classification criteria for hip osteoarthritis. Progression was defined as 20% joint space narrowing or total hip replacement within a two years follow up. Software was developed to calculate geometrical aspects and bone mineral density (BMD) in different regions of interest of the proximal femur. Logistic regression was used to test if Kellgren and Lawrence (K-L) scores and DXA parameters can predict progression of OA. Models were compared using -2log likelihood tests, R2 Nagelkerke and areas under the Receiver Operator Characteristic curves, assessed using 10-fold cross validation.ResultsThe model that included the DXA variables was significantly better in predicting hip OA progression than the model with K-L score of the affected side alone (P < 0.01). The addition of the differences in DXA parameters between the most affected and contralateral hip in the superior part of the femoral head, trochanteric and intertrochanteric area further improved the prediction of progression (P < 0.05). K-L score of the affected side was still the most significant single variable in the models.ConclusionsDXA parameters can significantly contribute to the prediction of progression in patients with hip osteoarthritis. The analysis of the DXA differences between the hips of the patient represents a small but significant contribution to this prediction. These analyses show the importance of bone density changes in the etiology of OA.

Bone parameters across different types of hip osteoarthritis and their relationship to osteoporotic fracture risk

“…Previous studies have found increased BMD and differences in DXA‐derived geometry values in OA hips as compared to controls without OA (19, 35–38). However, the majority of those studies used the classic definition of hip OA, which required the presence of cartilage degradation (joint space narrowing) and osteophytes.…”

Bone mineral density and joint cartilage: four clinical settings of a complex relationship in osteoarthritis

“…No difference in spine BMD was seen in women whose osteophytes or joint space width progressed compared with osteoarthritis non-progressors 6. By contrast, the GOAL trial demonstrated that patients with hip osteoarthritis progression had a higher bone mineral content in certain regions of the femoral head compared with non-progressing patients 37. Furthermore, a twin study showed an inverse relationship between osteoarthritis and osteoporosis at the osteoarthritis-affected hip, but no association was found between hip osteoarthritis and BMD at the contralateral site, lumbar spine, or total body 38…”

“…Although an extensive amount of literature shows an inverse relationship between osteoarthritis progression and osteoporosis,7–9 12 14 15 18 37 38 other studies did not reach the same conclusions 29 39. In addition, low hip BMD has been weakly related to knee osteoarthritis progression as assessed by osteophyte growth,6 while this association was not evident in those whose JSN had progressed 6 13.…”

Bone texture analysis for prediction of incident radiographic hip osteoarthritis using machine learning: data from the Cohort Hip and Cohort Knee (CHECK) study

“…Given the previous results showing that FSA can be applied on hip radiographs [22] and that bone density related parameters from dual energy X-ray absorptiometry (DXA) contribute to the risk and progression of hip OA [23][24][25][26], we hypothesize that radiography-based bone texture gives additional information in predicting the development of radiographic hip OA (rHOA). Consequently, our aim was to create a method for automated assessment of bone texture in proximal femur and acetabulum from plain hip radiographs and to assess the ability of these bone texture parameters to predict incident rHOA.…”