Evaluation of low bone mass and prediction of fracture risk using metacarpal radiogrammetry method: a comparative study with DXA and X‐ray phantom

Objectives (i) To predict the future risk of osteoporotic fracture in women using a simple forearm radiograph. (ii) To assess osteoporosis in southern Indian women by using radiogrammetric technique in comparison with dual‐energy X‐ray absorptiometry (DXA) and X‐ray phantom study. Methods The bone mineral density (BMD) of the right proximal femur by DXA and the X‐ray measurements were acquired from the right forearm. The combined cortical thickness at the second to fourth metacarpal region (M‐CCT), radius (R‐CCT) and ulna (U‐CCT) were derived in all the studied population. The aluminium phantom study was conducted by varying the X‐ray source to film distance at 100 cm and 150 cm, respectively. The feed forward back propagation neural network was used for classification of low bone mass group and normal. Results The combined cortical thickness of M‐CCT, R‐CCT and U‐CCT of the total studied population was strongly correlated with DXA femur Th.BMD measurements (r = 0.77, r = 0.61 and r = 0.59 [P