Reliability of radiological indices in comparison with dual energy x-ray absorptiometry in diagnosis of osteoporosis: A cross-sectional study

Abstract

Background: Osteoporosis projects a dominant issue related to health in the community in developing country like ours –India and is often unrecognised or undiagnosed. Early Diagnosis and treatment of osteoporosis is of utmost importance. This study evaluates the accuracy of Radiological Indices in comparison to gold standard DEXA scan for diagnosis of osteoporosis, so that diagnosis of Osteoporosis can be done using simple radiographs which would be cost effective and less exposure to radiation. Methods and Material: The is study is a one year hospital based comparative study which included a total of 80 patients who presented to OPD / IPD of Department of Orthopaedics and met the inclusion criteria were enrolled in the study. Patients were subjected to DEXA scan and a plain radiograph of either of the hip joint with full length femur in AP and Lateral views. Subsequently, the Singh’s Index, Cortical Thickness Index(CTI) AP and Lateral, Calcar to Canal Ratio (CCR) were measured and compared with the standard DEXA scan. Statistical analysis used: Spearman’s Rank co-efficient was used to find correlation between Radiological Indices and DEXA scan, Kappa Statistics for level of agreement, Sensitivity and Specificity for Radiological Indices was calculated. Results: The data analysed showed significant correlation (Spearman co-efficient) between Radiological Indices and DEXA scan. Cortical thickness index Antero-posterior view and Lateral view with cut-off 0.43(r=0.8172, p< 0.0001 and r=0.8243, p< 0.0001 respectively), calcar to canal ratio with cut-off 0.50 (r=0.8188, p< 0.0001). Similarly for Singh’s Index (r=0.6002, p< 0.0001). Conclusion: Radiological indices are reliable in the diagnosis of Osteoporosis and have a good correlation with T scores decuded by DEXA scan.