Hyperostosis frontalis interna in postmenopausal women—Possible relation to osteoporosis

Danijela Djonic, Djurdja Bracanovic, Zoran Rakocevic, Miomira Ivovic, Slobodan Nikolic, Vladimir Zivkovic, Marija Djuric

To improve our understanding of hyperostosis frontalis interna (HFI), we investigated whether HFI was accompanied by changes in the postcranial skeleton. Based on head CT scan analyses, 103 postmenopausal women were divided into controls without HFI and those with HFI in whom we measured the thickness of frontal, occipital and parietal bones. Women in the study underwent dual energy x-ray absorptiometry to analyze the bone density of the hip and vertebral region and external geometry of proximal femora. Additionally, all the women completed a questionnaire about symptoms and conditions which could be related to HFI. Women with HFI had a significantly higher prevalence of headache, neurological and psychiatric disorders and a significantly lower prevalence of having given birth. Increased bone thickness and altered bone structure in women with HFI was localized only on the skull, particularly on the frontal bone, probably due to specific properties of its underlying dura. Bone loss in the postcranial skeleton showed the same pattern in postmenopausal women with HFI as in those without HFI. Recording of HFI in medical records can be helpful in distinguishing whether reported disorders occur as a consequence of HFI or are related to other diseases but does not appear helpful in identifying women at risk of bone loss.