title: Hip fracture discrimination by imaging ultrasound measurements of the calcaneus.
abstract: Quantitative ultrasound measurements of the os calcis have recently been upgraded with imaging facilities. This has made measurements of a specific region of interest possible and improved the reproducibility of the method, but the diagnostic ability of imaging ultrasound has not yet been investigated thoroughly. We measured broadband ultrasound attenuation (BUA) and speed of sound (SOS) using imaging ultrasound as well as forearm bone mineral density (BMDarm) using dual-energy X-ray absorptiometry in three age-matched groups of women: (1) 25 women who were admitted to hospital due to a hip fracture; (2) 23 women who were admitted to hospital due to a fall without any fracture; and (3) 26 normal women. Furthermore, BMD of the hip (BMDhip) was measured in a subgroup of the hip fracture patients and those who had fallen. All measurements were performed during the index hospitalization in order to avoid any influence from bone loss due to immobilization after the fracture. We found a -0.48 SD deviation from expected age-matched values in BUA among the hip fracture patients, whereas the patients who had fallen showed a +0.16 SD deviance. For SOS, the figures were -0.70 SD for the hip fracture group and -0.06 SD for the patients who had fallen. For BMD of the arm we found values of -0.65 SD and +0.08 SD, respectively, whereas the figures for BMD of the hip were -0.66 SD and +0.13 SD, respectively. All parameters were significantly lower in the hip fracture group compared with the patients who had fallen. None of the parameters in the patients who had fallen deviated significantly from expected normal age-matched values. Neither BMD of the arm or BMD of the hip separated hip fracture patients and patients who had fallen significantly better than ultrasound (BUA or SOS) did. We conclude that imaging ultrasound (BUA or SOS) separates age-matched groups of hip fracture and non-fracture patients as well as BMD measurements do.
authors.affiliation: Center for Clinical and Basic Research, Ballerup, Denmark.
authors.forename: S H
authors.initials: SH
authors.lastname: Prins
authors.forename: J
authors.initials: J
authors.lastname: Lauritzen
authors.forename: H L
authors.initials: HL
authors.lastname: Jørgensen
authors.forename: L
authors.initials: L
authors.lastname: Simonsen
authors.forename: C
authors.initials: C
authors.lastname: Hassager
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D002111:Calcaneus / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D005542:Forearm / Q000000981:diagnostic imaging* / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography