title: Using Hounsfield Units to Assess Osteoporotic Status on Wrist Computed Tomography Scans: Comparison With Dual Energy X-Ray Absorptiometry.
abstract: OBJECTIVE
  Rates of evaluation and treatment for osteoporosis following distal radius fragility fractures remain low. As a subset of patients with these fractures undergo diagnostic computed tomography (CT) scan of the wrist, utilizing bone mineral density (BMD) measurements available with this imaging can be used to detect osteopenia or osteoporosis. This information may consequently prompt intervention to prevent a subsequent fracture. The purpose of this study was to determine if Hounsfield unit (HU) measurements at the wrist correlate with BMD measurements of the hip, femoral neck, and lumbar spine and to assess the ability of these HU measurements to detect osteoporosis of the hip.
  
  
  METHODS
  Forty-five female patients with distal radius fractures who underwent CT scan and dual energy x-ray absorptiometry scan as part of the management of their wrist fracture were identified. Bone mineral density measurements were made using the regional cancellous bone HU value at the capitate and compared with values obtained by a dual energy x-ray absorptiometry scan.
  
  
  RESULTS
  Hounsfield unit values at the capitate were significantly correlated with BMD and t scores at the femoral neck, hip, and lumbar spine. An HU threshold of 307 in the capitate optimized sensitivity (86%) and specificity (94%) for detecting osteoporotic patients.
  
  
  CONCLUSIONS
  By demonstrating that capitate HU measurements from clinical CT scans are correlated with BMD and t scores at the hip, femoral neck, and lumbar spine, our data suggest that clinical CT scans should have a role in detecting osteopenia and osteoporosis.
  
  
  METHODS
  Diagnostic III.
authors.affiliation: Hospital for Special Surgery, New York, NY. Electronic address: johnsonc@hss.edu.
authors.forename: Christine C
authors.initials: CC
authors.lastname: Johnson
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Gausden
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Weiland
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lane
authors.affiliation: Hospital for Special Surgery, New York, NY.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Schreiber
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D051224:Capitate Bone / Q000000981:diagnostic imaging*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058866:Osteoporotic Fractures / Q000175:diagnosis; D011885:Radius Fractures / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Bone mineral density; Hounsfield unit; distal radius fracture; dual x-ray absorptiometry; osteoporosis