title: Fracture status in men assessed by quantitative ultrasound measurements at the calcaneus.
abstract: OBJECTIVE
  The aim of the study was to assess fracture status in men by quantitative ultrasound measurements at the calcaneus. The diagnostic accuracy of quantitative ultrasound measurements was evaluated at baseline and follow-up.
  
  
  METHODS
  We observed 165 men (baseline age ± SD, 59.84 ± 10.6 years) recruited from an outpatient osteoporosis clinic. The mean follow-up duration was approximately 101.3 ± 35 months. There was no difference in either age or body mass index at baseline between the patients with a fracture history (n = 30) and the others (n = 135). The following fractures were identified at baseline: ankle, 15; wrist, 10; rib, 9; foot, 5; and hip, 1. The speed of sound (meters per second), broadband ultrasound attenuation (decibels per megahertz), and stiffness index (percent) were measured with a quantitative ultrasound device. The date of fracture occurrence at follow-up was defined as the final point.
  
  
  RESULTS
  In the patients with a fracture history, the ultrasound variables were significantly lower than those in the rest of the group (P < .05). During the follow-up period, fractures occurred in 21 patients (wrist, 11; ankle, 5; rib, 3; hip, 1; and humerus, 1), and the ultrasound outcomes were nonsignificantly lower in the fractured men. The risk of fracture was estimated by the Cox regression analysis. A prior fracture was the only factor that significantly (4 times) increased the risk of a subsequent fracture (hazard ratio, 4.21; 95% confidence interval, 1.81-9.86; P < .001).
  
  
  CONCLUSIONS
  Calcaneus ultrasound measurements can distinguish between patients with fractures and those without. In follow-up, ultrasound measurements did not indicate an increased fracture risk; a prior osteoporotic fracture was the major prognostic factor.
authors.affiliation: Metabolic Bone Diseases Unit, Medical University of Silesia, 3 Maja 13/15 St, 41-800 Zabrze, Poland. osteolesna@poczta.onet.pl
authors.forename: Wojciech
authors.initials: W
authors.lastname: Pluskiewicz
authors.forename: Robert
authors.initials: R
authors.lastname: Wilk
authors.forename: Artur
authors.initials: A
authors.lastname: Wielgórecki
authors.forename: Krzysztof S
authors.initials: KS
authors.lastname: Golba
authors.forename: Bogna
authors.initials: B
authors.lastname: Drozdzowska
mesh_terms: D002111:Calcaneus / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D014463:Ultrasonography