Plenary Poster ANZBMS-MEPSA-ANZORS 2022

Discordance in paretic and non-paretic hips bone density in hemiplegic stroke patients – a cross-sectional multicenter retrospective study (#206)

Hoo Young Lee 1 , Byung-Mo Oh 1 , Jungeun Son 2 , Seung Don Yoo 2
  1. Seoul National University Hospital/National Traffic Injury Rehabilitation Hospital, Yangpyeong-Eub, Yangpyeong-Gun, GYEONGGI-DO, South Korea
  2. Dept. of Rehabilitation Medicine, KYUNG HEE UNIVERSITY HOSPITAL AT GANGDONG, Seoul, South Korea

Background

The diagnosis of osteoporosis is determined based on the lowest bone mineral density (BMD) T-score at the lumbar spine (LS) and hip. Bone loss after stroke escalates the risk of fractures, mainly in the hip, leading to further disability in individuals with stroke. However, there are occasional marked discordances between the T-score of paretic hip and LS or T-scores of paretic and non-paretic hips. We aimed to compare the BMD between the paretic and non-paretic hips and spine and each hip, and elucidate the relationship between the discordance and BMD of paretic hip.

Methods

The 753 hemiplegic stroke patients (360 male, 393 female) above 20 years of age with cerebral infarction or hemorrhage were analyzed. BMD in the lumbar, paretic, and non-paretic hip as well as the demographic variables were analyzed retrospectively.

Results

The concordance and discordance rates of the lowest T-score and BMD between both hips were evaluated. The BMDs of the femoral neck were different between both hips. There were also discrepancies between the T-scores of both femur neck and LS. The concordance rates were about 81% between bilateral femoral neck and 53.5% between paretic femur neck and LS.

Conclusions

Due to significant high discordance rate in BMD between both hips at the femoral neck and between paretic femoral neck and LS bilateral hip measurements using DEXA are recommended to avoid underestimating osteoporosis, to minimize subsequent bone loss and to prevent possible complications in patients who experience stroke.

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