Related Experiment Video
Updated: May 13, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
A comparison of bone density and bone morphology between patients presenting with hip fractures, spinal fractures or
Richard G Crilly1, Lizebeth Cox
1Division of Geriatric Medicine, Faculty of Medicine, University of Western Ontario, London, ON, Canada. rcrilly@uwo.ca
Insights
Identifying osteoporosis in hip fracture patients is challenging. Spinal fractures in hip fracture patients indicate poor bone density, suggesting they may benefit most from osteoporosis treatment.
Area of Science:
- Orthopedics
- Gerontology
- Bone Metabolism
Background:
- Defining osteoporosis and identifying treatment candidates post-hip fracture remains unclear.
- Universal treatment post-hip fracture lacks strong evidence; patient selection is crucial.
- This study investigates bone status to identify hip fracture patients who would respond best to antiresorptive agents.
Purpose of the Study:
- To compare bone status (cortical and trabecular) between patients with spinal fractures, hip fractures, and combined fractures.
- To identify a simple clinical method (spine X-ray) for selecting hip fracture patients most likely to benefit from osteoporosis treatment.
Main Methods:
- Comparison of three groups of 50 patients: spinal fracture only, hip fracture only, and combined fractures.
- Measurements included bone mineral density (lumbar spine, hip), spinal fracture assessment (Genant method), cortical bone thickness, and hip geometry.
Main Results:
- Spinal fracture patients exhibited the most deficient trabecular and cortical bone.
- Hip fracture patients without spinal fractures had the best trabecular bone and most cortical bone sites.
- Combined fracture patients showed intermediate bone status.
Conclusions:
- Spinal fractures in hip fracture patients signify poor trabecular bone, indicating a potential candidate group for therapy.
- Hip fracture patients without spinal fractures had bone mass within normal age and gender ranges.
- The presence of spinal fractures may identify hip fracture patients who would benefit most from antiresorptive therapy.
Background:
Currently it is uncertain how to define osteoporosis and who to treat after a hip fracture. There is little to support the universal treatment of all such patients but how to select those most in need of treatment is not clear. In this study we have compared cortical and trabecular bone status between patients with spinal fractures and those with hip fracture with or without spinal fracture with the aim to begin to identify, by a simple clinical method (spine x-ray), a group of hip fracture patients likely to be more responsive to treatment with current antiresorptive agents.
Methods:
Comparison of convenience samples of three groups of 50 patients, one with spinal fractures, one with a hip fracture, and one with both. Measurements consist of bone mineral density at the lumbar spine, at the four standard hip sites, number, distribution and severity of spinal fractures by the method of Genant, cortical bone thickness at the infero-medial femoral neck site, femoral neck and axis length and femoral neck width.
Results:
Patients with spinal fractures alone have the most deficient bones at both trabecular and cortical sites: those with hip fracture and no spinal fractures the best at trabecular bone and most cortical bone sites: and those with both hip and spinal fractures intermediate in most measurements. Hip axis length and neck width did not differ between groups.
Conclusion:
The presence of the spinal fracture indicates poor trabecular bone status in hip fracture patients. Hip fracture patients without spinal fractures have a bone mass similar to the reference range for their age and gender. Poor trabecular bone in hip fracture patients may point to a category of patient more likely to benefit from therapy and may be indicated by the presence of spinal fractures.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...