title: Can mandibular bone resorption predict hip fracture in elderly women? A systematic review of diagnostic test accuracy.
abstract: OBJECTIVE
  The aim of this systematic review was to determine the diagnostic accuracy of the mandibular cortical width measurements and porosity in detecting hip osteoporosis.
  
  
  BACKGROUND
  All of the included studies used measurements on panoramic radiographs.
  
  
  METHODS
  Studies were included if they compared the radiographic measurements (or index tests) with central dual energy X-ray absorptiometry (DXA) of the hip as the reference standard. A measure of diagnostic accuracy such as sensitivity and specificity or area under the receiver operating characteristic curve was also required for inclusion.
  
  
  RESULTS
  Seven studies were identified. Meta-analysis was not possible because of the heterogeneity of the studies. The studies all demonstrated moderate diagnostic accuracy.
  
  
  CONCLUSIONS
  If a patient with a thin or porous mandibular cortex is identified by a chance radiographic finding, additional clinical risk factors need to be considered and the patient referred for further investigation with DXA where necessary.
authors.affiliation: School of Dentistry, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: Devlin
authors.affiliation: Faculty of Life Sciences, University of Manchester, Manchester, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Whelton
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001862:Bone Resorption / Q000473:pathology*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006620:Hip Fractures; D006801:Humans; D008334:Mandible / Q000473:pathology*; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010384:Pelvic Bones / Q000473:pathology; D011379:Prognosis; D011862:Radiography, Panoramic / Q000379:methods*
keywords: bone resorption; hip fracture; mandible