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Updated: May 10, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
The association between hip bone marrow lesions and bone mineral density: a cross-sectional and longitudinal
H Ahedi1, D Aitken, L Blizzard
1Menzies Research Institute of Tasmania, University Of Tasmania, Hobart, Tasmania 7000, Australia.
Objective:
To describe the cross-sectional and longitudinal association between hip Bone marrow lesions (BMLs) and bone density.
Design:
198 subjects with a right hip MRI and dual-energy X-ray absorptiometry (DXA) scans conducted at two time points, approximately 2.6 years apart were included. MR images were used to assess hip BML presence and size (cm(2)) while DXA scans were used to determine bone mineral density (BMD) of the total hip, spine and femoral neck.
Results:
Fifty-five subjects (28%) had either a femoral and/or acetabular BML. Cross-sectionally, acetabular BMLs were associated with 5-6% lower total hip [P = 0.01] and femoral neck BMD [P < 0.001]. Resolving acetabular BMLs were associated with a 1-2% increase in BMD at hip [P = 0.05] and femoral neck [P = 0.01]. In contrast, resolving femoral BMLs were associated with a 4% lower and incident femoral BMLs with 3% higher femoral neck BMD [P = 0.04, P < 0.001 resp.]. Finally, each 1 cm(2) change femoral BMLs was associated with increase in femoral neck BMD: +0.03 g/cm(2), 95% confidence intervals (CI): +0.00, +0.05, and enlarging acetabular BMLs was associated with decrease in hip: -0.01 g/cm(2), 95% CI: -0.03, -0.00 and femoral neck BMD: -0.01 g/cm(2), 95% CI: -0.03, -0.001.
Conclusion:
Hip BMLs were associated with local BMD (hip and femoral neck) but not with spine BMD and these associations vary according to site. BML prevalence and change was low in this study, hence these findings need confirmation. However, we hypothesize that these associations represent a combination of changes related directly to the BML pathology or changes adjacent to the disease process.
Insights
Hip bone marrow lesions (BMLs) are linked to lower bone density in the hip and femoral neck. Changes in BMLs, such as resolution or enlargement, also correlate with bone mineral density (BMD) shifts.
Area of Science:
- Orthopedics
- Radiology
- Bone Metabolism
Background:
- Bone marrow lesions (BMLs) are common findings in hip magnetic resonance imaging (MRI).
- The relationship between hip BMLs and bone mineral density (BMD) requires further elucidation.
- Understanding this association is crucial for assessing fracture risk and guiding treatment.
Purpose of the Study:
- To investigate the cross-sectional and longitudinal associations between hip BMLs and BMD.
- To determine if BML presence, size, and changes over time correlate with BMD at the total hip, spine, and femoral neck.
Main Methods:
- 198 subjects underwent hip MRI and dual-energy X-ray absorptiometry (DXA) scans at baseline and approximately 2.6 years later.
- MR images were analyzed for hip BML presence and size (cm²).
- DXA scans measured BMD of the total hip, spine, and femoral neck.
Main Results:
- Acetabular BMLs were associated with 5-6% lower total hip and femoral neck BMD cross-sectionally.
- Resolving acetabular BMLs correlated with a 1-2% increase in hip and femoral neck BMD.
- Changes in femoral BML size were associated with alterations in femoral neck BMD, with larger BMLs linked to higher BMD.
Conclusions:
- Hip BMLs are associated with local BMD (hip and femoral neck), but not spine BMD.
- These associations vary by BML location.
- While BML prevalence and change were low, findings suggest a link between BML pathology and local bone density, warranting further investigation.
