Background: The Singh index is an inexpensive
simple method to evaluate bone density, commonly
used to assess osteoporosis is based on the radiological
appearance of the trabecular bone structure
of the proximal femur on a plain antero-posterior (AP)
radiograph. The purpose of this study was to compare
between Singh index and bone mineral density measurement
using dual energy X-ray absorptiometry
(DXA). Materials and Methods: Three orthopedists
evaluated radiographs of 72 patients suspected with
osteoporosis. The inter-observer agreements of the
Singh index were obtained by using kappa statistics.
The bone mineral density (BMD) of proximal femur
was measured by DXA in all patients, and then
the BMD results were compared with those of Singh
index by using reference radiographic charts of the
Singh index method. Dual-energy X-ray absorptiometry
was used to measure bone mineral density. A
Norland XR46 system was used for the investigations.
Results: The inter-observer agreement kappa values
were 0.01, 0.07 and 0.09 (mean value: 0.05) and the
strength of the observer agreements was negligible.
The obtained osteoporosis prevalence among the
studied patients was 38.9%. Conclusion: The
inter-observer variation was large, there was no any
correlation between the Singh index and bone
densitometry. So, the index cannot be used for
evaluating and osteoporosis diagnosis, because of its
low reliability. Iran. J. Radiat. Res., 2010 8 (2): 123-128
Salamat M, Rostampour N, Zofaghari S, Hoseyni-Panah H, Javdan M. Comparison of Singh index accuracy and dual energy X-ray absorptiometry bone mineral density measurement for evaluating osteoporosis. Int J Radiat Res 2010; 8 (2) :123-128 URL: http://ijrr.com/article-1-626-en.html