title: Correlation between Parameters of Calcaneal Quantitative Ultrasound and Hip Structural Analysis in Osteoporotic Fracture Patients.
abstract: BACKGROUND
  Calcaneal quantitative ultrasound (QUS), which is used in the evaluation of osteoporosis, is believed to be intimately associated with the characteristics of the proximal femur. However, the specific associations of calcaneal QUS with characteristics of the hip sub-regions remain unclear.
  
  
  METHODS
  A cross-sectional assessment of 53 osteoporotic patients was performed for the skeletal status of the heel and hip.
  
  
  METHODS
  We prospectively enrolled 53 female osteoporotic patients with femoral fractures. Calcaneal QUS, dual energy X-ray absorptiometry (DXA), and hip structural analysis (HSA) were performed for each patient. Femoral heads were obtained during the surgery, and principal compressive trabeculae (PCT) were extracted by a three-dimensional printing technique-assisted method. Pearson's correlation between QUS measurement with DXA, HSA-derived parameters and Young's modulus were calculated in order to evaluate the specific association of QUS with the parameters for the hip sub-regions, including the femoral neck, trochanteric and Ward's areas, and the femoral shaft, respectively.
  
  
  RESULTS
  Significant correlations were found between estimated BMD (Est.BMD) and BMD of different sub-regions of proximal femur. However, the correlation coefficient of trochanteric area (r = 0.356, p = 0.009) was higher than that of the neck area (r = 0.297, p = 0.031) and total proximal femur (r = 0.291, p = 0.034). Furthermore, the quantitative ultrasound index (QUI) was significantly correlated with the HSA-derived parameters of the trochanteric area (r value: 0.315-0.356, all p<0.05) as well as with the Young's modulus of PCT from the femoral head (r = 0.589, p<0.001).
  
  
  CONCLUSIONS
  The calcaneal bone had an intimate association with the trochanteric cancellous bone. To a certain extent, the parameters of the calcaneal QUS can reflect the characteristics of the trochanteric area of the proximal hip, although not specifically reflective of those of the femoral neck or shaft.
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Licheng
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Houchen
authors.initials: H
authors.lastname: Lv
authors.affiliation: Department of Bioengineering, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
authors.forename: Hailiang
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Pengbin
authors.initials: P
authors.lastname: Yin
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China.
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D015519:Bone Density; D002111:Calcaneus / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D055119:Elastic Modulus; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006620:Hip Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography