Comparison of dual-energy X-ray absorptiometry with six quantitative ultrasonometry devices in women with hip fractures

Abstract

Objectives Dual-energy X-ray absorptiometry (DXA) is the gold standard for assessment of bone mineral density, an important risk factor for osteoporotic fractures. Recent reports suggest that quantitative ultrasonometry (QUS) is able to predict fractures; however, only limited data in women with hip fractures are available.

Methods We examined 91 postmenopausal women who had sustained an osteoporosis-related hip fracture within the past 7 days using DXA and six different QUS devices and compared them with 91 healthy age-matched controls.

Results Femoral neck (FN), total hip (TH) and lumbar spine (LS) T-scores were lower in women with hip fractures compared to matched controls: − 2.38 vs. − 1.64 (p < 0.001), − 2.36 vs. − 1.44 (p < 0.001) and − 2.05 vs. − 1.50 (p = 0.41), respectively. The T-scores of the Achilles, Sahara, InSight and Omnisence QUS devices were also lower in patients with hip fractures compared to matched controls: − 3.20 vs. − 2.36 (p < 0.001), − 2.196 vs. − 1.761 (p = 0.005), − 2.631 vs. − 1.849 (p < 0.001), − 3.707 vs. − 3.030 (p = 0.032), respectively. However, the T-scores of the DBM and QUS-2 did not differ between the two groups: − 4.543 vs. − 4.324 (p = 0.352) and − 1.7 vs. − 2.0 (p = 0.465), respectively. Compared to DXA (hip), the odds ratios of the Achilles, InSight and Sahara were comparable, while the odds ratios of the DBM, Omnisence and QUS-2 were significantly lower (p ≤ 0.05).

Conclusions Compared to DXA, the Achilles, Sahara and InSight QUS devices showed similar hip fracture discrimination while the DBM, Omnisence and QUS-2 did not. Therefore, some QUS devices are able to identify a clinically meaningful risk factor in women at high risk of hip fracture.

Key words::

• HIP FRACTURE
• DXA
• QUANTITATIVE ULTRASONOMETRY
• BONE MINERAL DENSITY
• OSTEOPOROSIS

Authors’ contributions

I.K. and P.H. conceived the study, participated in its design and coordination, helped to draft the manuscript and made substantial contributions to analysis and interpretation of the data. P.I. and C.W. participated in the design of the study, made substantial contributions to acquisition of data and helped to draft the manuscript. U.S.A. made substantial contributions to acquisition of data and helped to draft the manuscript. O.H. participated in the design of the study and performed statistical analyses. All authors read and approved the final manuscript.

Conflict of interest All authors state that they have no conflicts of interest to declare.

Source of funding Nil.