SynthesisPloS one2025
CT Hounsfield units in assessing bone and soft tissue quality in the proximal femur: A systematic review focusing on osteonecrosis and total hip arthroplasty.
Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Evaluating osseointegration, bone remodeling and osteolysis after total wrist arthroplasty using photon-counting detector CT.Skeletal radiology · 2026Article
- Anatomy-driven automated subsegmentation of pelvic and proximal femoral CT into clinically relevant subregions and landmarks.BMC medical imaging · 2026Article
- Opportunistic CT assessment of psoas muscle attenuation and its association with lumbar osteoporosis in total hip arthroplasty candidates.Skeletal radiology · 2026Article
- BMI-stratified performance of native CT hounsfield units in the proximal femur for osteoporosis detection and fracture association.BMC musculoskeletal disorders · 2026Article
- [Trabecular bone density measurement in Hounsfield units in the proximal femur for osteoporosis assessment and fracture risk determination].Orthopadie (Heidelberg, Germany) · 2026Article
- Potential Role of Imaging in the Evaluation of Adiposity and Approval of Anti-Obesity Drugs.Korean journal of radiology · 2026Review
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12 authors.
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Abstract
backgroundComputed tomography (CT) Hounsfield Units (HU) offer valuable insights into the changes in bone and soft tissue densities, playing a crucial role in the diagnosis and management of various proximal femur conditions. This systematic review aims to consolidate the application of HU in assessing tissue quality in the proximal femur, with a special focus on osteonecrosis of the femoral head (ONFH) and implications for total hip arthroplasty (THA), thereby addressing unresolved issues in these areas.
methodsWe conducted a comprehensive literature search on MEDLINE/PubMed, EMBASE, Google Scholar, SpringerLink, Scops, Web of Science, and Bentham Science Publishers from inception to January 2024, following the PRISMA guidelines, to retrieve all studies relevant to the application of HU in assessing both bone and soft tissue quality of the proximal femur, particularly in the context of ONFH and THA. We systematically evaluated the key findings extracted from the included articles.
resultsThis systematic review included a total of 58 studies, involving 15,668 patients. The sample sizes ranged from 50 to 685, with the CT slice thickness varying from 0.5 mm to 10 mm. The results mainly focused on three areas: (1) the relationship between HU and the density of proximal femoral tissues (n = 33); (2) the assessment of HU in predicting the risk of femoral head collapse (n = 10); (3) the application of HU during the perioperative period of THA (n = 15).
conclusion(1) HU can effectively contribute to the evaluation of bone and soft tissue densities in the proximal femur, and reflect local stress changes. (2) In ONFH patients, bone density does not decrease in the necrotic area of the femoral head before collapse. However, abnormally elevated HU at the outer boundary of the necrotic lesion are significant in assessing collapse risk. (3) HU can be used to preoperatively assess hip bone quality for THA, guide surgical approaches, predict intraoperative fractures, monitor postoperative bone ingrowth or absorption, identify and quantitatively evaluate periprosthetic loosening, and guide postoperative rehabilitation.
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