Discriminative ability of calcaneal quantitative ultrasound compared with dual-energy X-ray absorptiometry in men with hip or distal forearm fractures.
OBJECTIVE
The aim of this case-control study was to compare the discriminatory ability of bone mineral density (BMD) measurements and calcaneal quantitative ultrasound (QUS) parameters for fractures and to determine fracture thresholds for each variable in men with hip or distal forearm fractures.


METHODS
A total of 20 men with hip and 18 men with distal forearm fractures and 38 age-matched controls were included in this study. Dual-energy X-ray absorptiometry (DXA) BMD (spine and hip) and calcaneal QUS measurements were made. Area under the curves (AUCs) were calculated to assess fracture discriminatory power of DXA and QUS variables.


RESULTS
Quantitative Ultrasound Index (QUI) T-score and Speed of Sound (SOS) were found to be the best parameters for the identification of hip and distal forearm fractures, respectively, with AUCs greater than those of DXA BMD and other QUS parameters. While a QUI T-score of ≤-1.18 could identify and rule out hip fracture cases with approximately 80% sensitivity and specificity, a SOS value of ≤1529.75 reached to almost 90% for ruling in and out distal forearm fractures.


CONCLUSIONS
The discriminatory performance of calcaneal QUS variables between fractured and non-fractured men was as good as those of the DXA BMD and even better. Since men appear to sustain fractures at closer QUS variable levels than those of the DXA BMD regardless of the fracture type, it may be speculated that calcaneal QUS may be more helpful in predicting the risk of fractures when BMD alone does not demonstrate impaired bones.


METHODS
Level III, Study of Diagnostic Test.
Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Fatih
F
Cesme
Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey. Electronic address: sinabox@gmail.com.
Sina
S
Esmaeilzadeh
Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Aydan
A
Oral
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002111:Calcaneus / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D005543:Forearm Injuries / Q000000981:diagnostic imaging*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006620:Hip Fractures / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D012680:Sensitivity and Specificity; D014463:Ultrasonography
Calcaneal quantitative ultrasound; Distal forearm fractures; Dual-energy X-ray absorptiometry; Hip fractures; Osteoporosis
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