1.Association of osteoporosis with radiologic grading of the hip among older Filipino patients with suspected hip osteoarthritis
Carl Johnry J. Santos ; Seth Gabriel F. Estanislao ; Irene S. Bandong
The Philippine Journal of Nuclear Medicine 2022;17(2):22-34
Introduction:
Among older populations, osteoarthritis (OA) is one of the most common chronic joint disorders and is a
leading cause of disability, while osteoporosis is the most common metabolic bone disease, conferring fragility
and significant risk of fracture. The relationship between OA and osteoporosis remains controversial. Although
earlier studies reported an inverse association between the two diseases, more recent literature found a
complex relationship mediated by various factors.
Objective:
The investigators sought to determine the association of osteoporosis with radiologic grading of the hip among
older Filipino patients with suspected hip osteoarthritis.
Methodology:
A cross-sectional analytical study was conducted involving 256 patients with suspected hip OA who underwent
radiography of the hips and central dual energy x-ray absorptiometry (DXA). Radiographs of the hips were
evaluated by a radiologist using the Kellgren-Lawrence (KL) grading scale, while central DXA images were
processed and evaluated by a nuclear medicine physician using the World Health Organization criteria for the
diagnosis of osteoporosis and the 2019 International Society for Clinical Densitometry guidelines. The primary
outcome measures were the prevalence of osteoporosis in patients with suspected hip OA, and the association
of osteoporosis with radiologic KL grading of the hips. The secondary outcome measure was the association of
osteoporosis with sex and BMI.
Results:
The study found that osteoporosis was present in 136 (53.1%) of the 256 patients who all presented with
radiologic evidence of hip OA. There was a positive association between the presence of osteoporosis and the
radiologic grade of hip OA (p-value: 0.006 on the right hip and 0.036 on the left). Osteoporosis was more
prevalent in women compared to men (p-value: 0.031). Likewise, osteoporosis had a direct relationship with
BMI (p-value: <0.001).
Conclusion
Osteoporosis was prevalent in a significant proportion of older Filipino patients with clinical and radiologic
evidence of hip OA, particularly among women, and was positively associated with increasing severity of OA.
The study suggests that obesity may not necessarily protect against osteoporosis in this population, possibly
relating to increased adiposity and decreased lean muscle mass.
Osteoporosis
;
Osteoarthritis
;
Osteoarthritis, Hip
;
Absorptiometry, Photon