Abstract
Understanding bone mineral density and its effects on patient outcomes is a useful
tool for lower extremity surgeons. Historically, dual-energy X-ray absorptiometry
scans have been the gold standard for quantifying bone mineral density. In this study,
we look at an indirect way to measure bone mineral density using Hounsfield units
on computed tomography. The aim of this study is to establish normal physiological
Hounsfield ranges in specific bones of the foot by analyzing Hounsfield unit measurements
and determining associated factors. We hypothesize that there will be a difference
in density based on age, sex, and anatomic location. Patient data from January 2010
to January 2020 were retrospectively analyzed from 2 institutions. Nine anatomic locations
(calcaneus, talar body, talar head, navicular, cuboid, medial cuneiform, head of first
and fifth metatarsal, and base of first proximal phalanx) were measured for bone mineral
density averages. In total, 137 patients were evaluated (71 males, 66 females) with
an average age of 54 years. Significant differences in density were found between
the 9 anatomic locations. Age was confirmed to be a significant covariate with inverse
relation to Hounsfield units, p < .001. There were no density differences between sexes at any of the locations,
except the talar head, p < .001. This is the first study to our knowledge to establish normal physiological
ranges of bone density on computed tomography for specific anatomic locations of the
foot. This quantitative approach to bone density and the established effect of age,
sex, and location is pivotal for diagnostic and preoperative planning.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 12, 2022
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
