{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:45:19Z","timestamp":1792097119824,"version":"4.4.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Fragility fractures reveal osteoporosis, but ankle fractures are not consistently defined as fragility fractures. CT-derived Hounsfield unit measurements may provide an opportunistic method to identify patients at risk for osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study investigated the relationship between Hounsfield units (HU) from ankle CT scans and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DEXA), with the aim of determining whether sufficient signal exists between ankle HU and DEXA-derived BMD to justify a larger prospective validation study, rather than to establish a definitive diagnostic tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design\/Level of Evidence:<\/jats:title>\n                    <jats:p>Retrospective correlation study. Level III.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients aged 55 years or older, who underwent open reduction and internal fixation for OTA\/AO 44 A-C ankle fractures between 2012 and 2024 and had both a preoperative ankle CT and a DEXA scan within 1 year of injury, were reviewed. HU values of the distal tibia and fibula were measured using standardized elliptical regions of interest. Multivariate linear regression was performed with the lowest DEXA T-score as the dependent variable, with HU values, and BMI as independent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 57 patients (87.7% female, mean age 69.67 \u00b1 9.24 years) were included. The average ankle HU was 192.43 \u00b1 60.04, and the mean T-score was \u22121.73 \u00b1 0.96. Regression analysis demonstrated that HU values (B = 0.005,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .021) and BMI (B = 0.064,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007) were positively correlated with the T-score.\n                    <\/jats:p>\n                    <jats:p>The regression model was lowest T-score = 0.005*Ankle HU + 0.064*BMI\u20134.422.<\/jats:p>\n                    <jats:p>Based on this equation, an HU measurement of 106.64 or less, assuming a BMI of 21.7, correlated with osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Ankle HU values from CT scans demonstrated a positive association with DEXA-derived BMD, supporting proof-of-concept for ankle HU as a preliminary screening tool and providing methodological groundwork for future prospective validation. Given the high prevalence of osteopenia or osteoporosis in this population, ankle fractures should prompt formal bone health evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bh9.0000000000000062","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:00:08Z","timestamp":1792094408000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of opportunistic osteoporosis screening using ankle CT Hounsfield units in older adults with ankle fractures"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6064-1127","authenticated-orcid":false,"given":"Alexander","family":"Lashgari","sequence":"first","affiliation":[{"name":"NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Bueno","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8488-2677","authenticated-orcid":false,"given":"Sanjit R.","family":"Konda","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0341-7683","authenticated-orcid":false,"given":"Kenneth A.","family":"Egol","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6609-2065","authenticated-orcid":false,"given":"Abhishek","family":"Ganta","sequence":"additional","affiliation":[{"name":"NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY"},{"name":"Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"R1-20261015","first-page":"e74065","article-title":"Advancements in the management of fragility fractures in orthopaedic patients","volume":"16","author":"Locke","year":"2024","journal-title":"Cureus"},{"key":"R3-20261015","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1177\/10711007231178536","article-title":"A comparison of ankle fractures relative to other fragility fractures: a review and analysis of the American orthopaedic association's own the bone database","volume":"44","author":"So","year":"2023","journal-title":"Foot Ankle Int"},{"key":"R4-20261015","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1002\/jbmr.5650110920","article-title":"Predictors of ankle and foot fractures in older women. 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