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Updated: Aug 16, 2026
Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
Bone shape, structure, and density as determinants of osteoporotic hip fracture: a pilot study investigating the
Jennifer S Gregory1, Alison Stewart, Peter E Undrill
1Department of Orthopaedics, University of Aberdeen, Aberdeen, Scotland, U.K. j.gregory@abdn.ac.uk
Objectives:
This article compares and combines methods for examining the external shape and the internal structure of the proximal femur with bone mineral density (BMD) to provide a classifier for hip fracture.
Materials And Methods:
Fifty standard pelvic radiographs were available from age-matched fracture and control groups of postmenopausal women. Femoral shape was measured using an active shape model, the trabecular structure by means of a Fourier transform.
Results:
Both the shape and various structure measures were independent of BMD (P=0.16 and >0.50, respectively). Calculating the area under the receiver operator characteristic (ROC) curve (Az), each of shape (Az=0.81), the best structure measure (Az=0.79-0.93), and BMD (Az=0.79), could partially classify the fracture and control groups. However, the combination achieved almost perfect separation (Az=0.99).
Conclusions:
This pilot study shows how bone shape and structure can complement BMD measurements for investigations of fracture risk.
