Heel DXA T-scores and panoramic radiographs in the prediction of hip and hand fractures

Introduction: We assessed if DXA (Dual Energy X-ray Absorptiometry) and panoramic radiographs were predictive of hip and or hand fractures over 3 years in older subjects. Methods: DXA heel measurements and mandibular panoramic bone scores (MPBS) from panoramic radiographs were performed in 418 women (mean age: 77.5 years, S.D ± 9.3 and 370 men (mean age: 76.4, S.D ± 9.5). Results: 4.5% subjects (34/788) had a hip and 3.7% (27/788) a hand fracture. A DXA T -score < - 2.5 (osteoporosis) in women and men was found in 16.3% and 8.1% respectively. Subjects with osteoporosis had fewer remaining teeth (mean diff: 4.4, 95% CI: 2.3–6.5, P < 0.001). A DXA T-score < -2.5 was predictive of a hip or hand fracture odds ratio 2.6:1(95%CI: 1.3-5.3, P < = 0.008). The odds ratio (OR) that a MPBS = 1 agreed with a DXA T-score <- 2.5 was 5.4:1 (95% CI: 2.6 – 11.4.2, P <0.001; Cochran c2 = 36.5, P < 0.001). The MPBS score = 1 had an OR of 3.3:1 (95%CI: 1.9–5.9, P < 0.001) in fracture prediction. Conclusions: The MPBS scores were consistent with the DXA T scores. Both methods have similar predictive value in assessing risk for future hip and hand fractures in older subjects. Subjects with osteoporosis had fewer remaining teeth.