Osteoarthritis (OA) is a common joint disease found mostly in the elderly that progressively leads to the loss of articular cartilage, along with subchondral bone changes (sclerosis) and joint space narrowing, eventually resulting in joint failure. Osteoporosis (OP), another bone disorder mostly of the elderly, is the gradual loss of bone tissue mass (bone mineral density (BMD)) resulting in reduction in bone strength and an increased risk of fracture. Bone geometry also plays a role in developing a fracture or not. OA causes increase in bone volume, but fracture is still prevalent in OA patients. The aim of this study was to investigate association of upper femur geometry and texture features to hip OA and hip fracture using radiography.

Supine anteroposterior radiographs of hip and BMD from 125 postmenopausal women were used for this research. Hip geometry parameters and texture related parameters were obtained from the radiographs. Participants’ weight, height, and body mass index (BMI) were also used in this research.

OA was found in women with higher weight, BMI, femur neck BMD, neck diameter (ND), and neck cortex thickness, and shorter joint space width (JSW). OA women also had higher homogeneity index of Laplacian images of femur neck and lower entropy of Laplacian images of femur neck. Fractures were more common among women with lower neck BMD, and higher femoral neck axis length, JSW, hip axis length (HAL) and acetabular width (w). For cervical fractures, JSW and w were higher. Women with trochanteric fractures had lower neck BMD and head diameter, and higher ND and HAL.

Upper femur geometry may play a role in the initiation and progression of OA and OP, and trabecular microarchitectural changes in OA are relatively distinct. Higher weight, BMI and neck BMD are predisposing factors for OA. Lower neck BMD is a predisposing factor for trochanteric fracture.