ArticleArchives of osteoporosis2023
The effect of patient positioning on measurements of bone mineral density of the proximal femur: a simulation study using computed tomographic images.
Article in Archives of osteoporosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Assessing bone microstructure and density with photon-counting CT: emerging applications and challenges.Skeletal radiology · 2026Review
- Bone mineral density measurement in the Gruen zones using dual-energy x-ray absorptiometry : insights from quantitative CT analysis.Bone & joint research · 2025Article
- The effect of forearm rotation on the bone mineral density measurements of the distal radius.Journal of bone and mineral metabolism · 2024Article
- The effect of femur positioning on dual-energy X-ray absorptiometry (DXA) measures and statistical shape and appearance modeling (SSAM) fracture risk assessments.Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine · 2024Article
- Enhanced Deep-Learning-Based Automatic Left-Femur Segmentation Scheme with Attribute Augmentation.Sensors (Basel, Switzerland) · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The patient's position may affect the bone mineral density (BMD) measurements; however, the extent of this effect is undefined. This CT image-based simulation study quantified changes in BMD induced by hip flexion, adduction, and rotations to recommend appropriate patient positioning when acquiring dual-energy x-ray absorptiometry images. PURPOSE: Several studies have analyzed the effect of hip rotation on the measurement of bone mineral density (BMD) of the proximal femur by dual-energy x-ray absorptiometry (DXA). However, as the effects of hip flexion and abduction on BMD measurements remain uncertain, a computational simulation study using CT images was performed in this study.
methodsHip CT images of 120 patients (33 men and 87 women; mean age, 82.1 ± 9.4 years) were used for analysis. Digitally reconstructed radiographs of the proximal femur region were generated from CT images to calculate the BMD of the proximal femur region. BMD at the neutral position was quantified, and the percent changes in BMD when hip internal rotation was altered from -30° to 15°, when hip flexion was altered from 0° to 30°, and when hip abduction was altered from -15° to 30° were quantified. Analyses were automatically performed with a 1° increment in each direction using computer programming.
resultsThe alteration of hip angles in each direction affected BMD measurements, with the largest changes found for hip flexion (maximum change of 17.7% at 30° flexion) and the smallest changes found for hip rotation (maximum change of 2.2% at 15° internal rotation). The BMD measurements increased by 0.34% for each 1° of hip abduction, and the maximum change was 12.3% at 30° abduction.
conclusionThis simulation study quantified the amount of BMD change induced by altering the hip position. Based on these results, we recommend that patients be positioned carefully when acquiring DXA images.
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