• Fadi Hadidi, Osama A Khalil, Azmy Alhadidy, Rula Alqawaba, Yazan Hammad, Omar Q Samarah, Mohammad Hamdan, Mohamad Samih Yasin, Ala' F Hawa, and Aldeen AlRyalat.
• Special Surgery Department, Division of Orthopedic Surgery, Jordan University Hospital, Amman, Jordan.
• Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14784.

PurposeThe purpose of this study is to determine if there is a relationship between radiological parameters measured using a plain X-ray and DXA scan score, and whether a plain X-ray can be used as surrogate imaging modality when DXA scan is not readily available.MethodsWe included all patients who had both a DXA scan and a pelvis X-ray done from 1 January 2013 to 31 December 2017. Bone mineral density had been measured by DXA scanning of the femoral neck and the spine. Osteoporosis was defined by T-score of any site less than -2.5. Cortical thickness indices on the AP radiograph were calculated.ResultsSixty patients were involved in the study and were divided into two groups. Group A had 22 patients who had a T-Score on their DXA Scans ≤-2.5 SD at the femur neck or the spine with median ± SD (-2.5 ± 0.8, -2.8 ± 1.0), respectively. Group B had 38 patients who had a T-score on their DXA Scans of >-2.5 at the femur neck and the spine with median ± SD (-1.2 ± 0.9, -1.3 ± 1.0), respectively, which was significantly higher than the T-score of osteoporotic (group A) patients (P = .000) at both sites of measurement. The cortical thickness index (CTI) was significantly higher (P = .027) in group B mean ± SD (0.56 ± 0.07), compared with (0.51 ± 0.08) that in group A.ConclusionDXA imaging remains the gold standard for diagnosing osteoporosis and we advocate the use of CTI to detect the patients who need DXA screening in places where this modality is not readily available.© 2021 John Wiley & Sons Ltd.

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