Comparison of bone density of femoral neck and spine in interstitial lung disease and chronic obstructive pulmonary disease

Abstract EN

Objective : To determine bone mineral density (BMD) of femoral neck and spine in Interstitial Lung Disease (ILD) and chronic obstructive pulmonary disease (COPD) to avoid fractures at those points.

Methodology : The study was conducted on seventy patients complaining of low back pain and pain related to hip joint.

Their mean age was 39 ± 7 years.

They were subjected to full history taking, physical examination, pulmonary function tests (PFT), plain chest X-ray and routine laboratory investigations.

According to PFT, patients were grouped into patients with obstructive pattern and patients with restrictive pattern, taking steroids or not.

They were all examined with dual energy X-ray absorptiometry (DXA).

Results : Twenty-five patients on oral steroids showed femoral osteopenia 32% and osteoporosis 48%.

Twenty-five patients on inhaled steroids showed osteopenia 48%, osteoporosis 12%.

Twenty patients taking no steroids showed 7% osteoporosis, no osteopenia.

As regard spine DXA, patients on oral steroids showed 40%, osteopenia, 12%, and osteoporosis.

Those on inhaled steroids showed 32% osteopenia, 4% osteoporosis.

Patients taking no steroids showed 25% osteopenia.

In patients taking oral or inhaled steroids, there was no significant difference between total femur and spine density with DXA (p = 0.177 for oral and p = 0.112 for inhaled steroids).

However, there was significant difference between femoral neck and spine density with DXA (p = 0.002 for oral, p = 0.000 for inhaled steroids).

Conclusions : Obstructive or restrictive lung disease patients have low bone mineral density, significantly more in those under steroid therapy, especially femoral neck.

DXA neck femur could be a screening test for such patients on steroid therapy.