Bone shape, structure and density as determinants of osteoporotic hip fracture

Jennifer Susan Gregory, Alison Stewart, Peter Edward Undrill, David M Reid, Richard Malcolm Aspden

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)


Objectives: This article compares and combines methods for examining the external shape and the internal structure of the proximal femur with bone mineral density (BMD) to provide a classifier for hip fracture.

Materials and Methods: Fifty standard pelvic radiographs were available from age-matched fracture and control groups of postmenopausal women. Femoral shape was measured using an active shape model, the trabecular structure by means of a Fourier transform.

Results: Both the shape and various structure measures were independent of BMD (P = 0.16 and > 0.50, respectively). Calculating the area under the receiver operator characteristic (ROC) curve (A(z)), each of shape (A(z) = 0.81), the best structure measure (A(z) = 0.79-0.93), and BMD (A(z) = 0.79), could partially classify the fracture and control groups. However, the combination achieved almost perfect separation (A(z) = 0.99).

Conclusions: This pilot study shows how bone shape and structure can complement BMD measurements for investigations of fracture risk.

Original languageEnglish
Pages (from-to)591-597
Number of pages6
JournalInvestigative Radiology
Issue number9
Publication statusPublished - Sept 2005


  • shape
  • density
  • structure
  • fracture
  • osteoporosis
  • finite-element-analysis
  • power-spectral-analysis
  • mineral density
  • trabecular bone
  • proximal femur
  • femoral-neck
  • mechanical-properties
  • distal radius
  • geometry
  • radiographs


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