Estimating hip fracture risk from digital x-ray image data

The authors propose a method for determining the risk of femoral neck fracture in osteoporotic patients that is not based on densitometric techniques. The method is based on a structural analysis performed by a computer on data taken from a single digital anteroposterior projection of the hip. From the image, the effective cross-sectional area and cross-sectional moment of inertia are computed from attenuation principles. Together with other geometric measurements, these data are used in an engineering analysis to compute the yield strength of the proximal femur, under stress applied through the acetabulum in a one-legged stance. An index of fracture risk based on the ratio of estimated yield strength to body weight is proposed. Ultimately it is expected that this work will allow the clinician to estimate hip fracture risk in osteoporotic patient using widely available existing technology, a goal which has eluded bone density-based methods