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Ultrasound bone densitometry of Os calcis in elderly Japanese women with hip fracture

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Abstract

We evaluated 138 elderly patients (mean age 79 years) within 2 weeks after hip fracture (67 cervical and 71 trochanteric) using an Achilles ultrasound bone densitometer (Lunar Corporation, Madison, WI). The ultrasound variables of speed of sound (SOS in m/second), broadband ultrasound attenuation (BUA in dB/MHz), and stiffness (%) index were measured on the os calcis. Ultrasound densitometry also was done on 563 normal postmenopausal women to assess normal age changes. An elderly subgroup (n = 138) served as age-matched controls for the hip fracture group. Further subgroups of 33 patients and 33 controls were compared for lumbar spine and femoral neck BMD. There were no statistically significant differences between the hip fracture group and age-matched controls in height and weight, but each ultrasound variable was significantly lower for the hip fracture group (P < 0.0001). For the hip fracture group, SOS was 1470 ± 19 m/second, BUA was 84.3 ± 8.4 dB/MHz, and the stiffness index was 47.8 ± 9.2%, whereas for the age-matched controls, SOS was 1486 ± 27 m/second, BUA was 94.0 ± 11.4 dB/MHz, and the stiffness index was 59.1 ± 12.5%. There were no significant differences between cervical and trochanteric hip fracture groups. Logistic regression analysis showed that a change of the ultrasound values by 1 standard deviation (SD) changed the odds ratio for SOS, BUA, and stiffness index by 2.51, 3.24, and 3.60, respectively. Ultrasound variables, particularly stiffness, were good indicators of hip fracture risk.

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References

  1. Melton LJ (1995) How many women have osteoporosis now? J Bone Miner Res 10: 175–177

    PubMed  Google Scholar 

  2. Johnell O (1995) Prevention of fractures in the elderly. Acta Orthop Scand 66: 90–98

    PubMed  CAS  Google Scholar 

  3. Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Palermo L, Scott J, Vogt TM (1993) Bone density at various sites for prediction of hip fractures. Lancet 341: 72–75

    Article  PubMed  CAS  Google Scholar 

  4. Nevitt MC, Johnell O, Black DM, Ensrud K, Genant HK, Cummings SR (1994) Bone mineral density predicts non-spine fractures in very elderly women. Osteoporosis Int 4: 325–331

    Article  CAS  Google Scholar 

  5. Cheng S, Suominen H, Era P, Heikkinen E (1994) Bone density of the calcaneus and fractures in 75- and 80-year-old men and women. Osteoporosis Int 4: 48–54

    Article  CAS  Google Scholar 

  6. Duboeuf F, Braillon P, Chapuy MC, Haond P, Hardoin C, Meary MF, Delmas PD, Meunier PJ (1991) Bone mineral density of the hip measured with dual-energy x-ray absorptiometry in normal elderly women and in patients with hip fracture. Osteoporosis Int 1: 242–249

    CAS  Google Scholar 

  7. Vega E, Mautalen C, Gomez H, Garrido A, Melo L, Sahores AO (1991) Bone mineral density in patients with cervical and trochanteric fractures of the proximal femur. Osteoporosis Int 1: 81–86

    Article  CAS  Google Scholar 

  8. Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM (1995) Risk factors for hip fracture in white women. N Engl J Med 332: 767–773

    Article  PubMed  CAS  Google Scholar 

  9. Faulkner KG, Cummings SR, Black D, Palermo L, Gluer CC, Genant HK (1993) Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Miner Res 8: 1211–1217

    Article  PubMed  CAS  Google Scholar 

  10. Avioli LV (1988) Ultrasound transmission velocity in screening for bone fragility. J Bone Miner Res 3: S215

    Google Scholar 

  11. Langton CM, Ali AV, Riggs CM, Evans GP, Bonfield W (1990) A contact method for the assessment of ultrasonic velocity and broadband attenuation in cortical and cancellous bone. Clin Phys Physiol Meas 11: 243–249

    Article  PubMed  CAS  Google Scholar 

  12. Zagzebski JA, Rossman PJ, Mesina C, Mazess RB, Madsen EL (1991) Ultrasound transmission measurements through the os calcis. Calcif Tissue Int 49: 107–111

    Article  PubMed  CAS  Google Scholar 

  13. Gluer CC, Vahlensieck M, Faulkner KG, Engelke K, Black D, Genant HK (1992) Site-matched calcaneal measurements of broad-band ultrasound attenuation and single x-ray absorptiometry: do they measure different skeletal properties? J Bone Miner Res 7: 1071–1079

    PubMed  CAS  Google Scholar 

  14. Faulkner KG, McClung MR, Coleman LJ, Kingston-Sandahl E (1994) Quantitative ultrasound of the heel: correlation with densitometric measurements at different skeletal sites. Osteoporosis Int 4: 42–47

    Article  CAS  Google Scholar 

  15. vanDaele PLA, Burger H, Algra D, Hofman A, Grobbee DE, Birkenhager JC, Pols HAP (1994) Age-associated changes in ultrasound measurements of the calcaneus in men and women: the Rotterdam study. J Bone Miner Res 9: 1751–1757

    Article  CAS  Google Scholar 

  16. McCloskey EV, Murray SA, Miller C, Charlesworth D, Tindale W, O’Doherty DP, Bickerstaff DR, Hamdy NAT, Kanis JA (1990) Broadband ultrasound attenuation in the os calcis: relationship to bone mineral at other skeletal sites. Clin Sci 78: 227–233

    PubMed  CAS  Google Scholar 

  17. Tavakoli MB, Evans JA (1991) Dependence of the velocity and attenuation of ultrasound in bone on the mineral content. Phys Med Biol 36: 1529–1537

    Article  PubMed  CAS  Google Scholar 

  18. Gluer CC, Wu CY, Jergas M, Goldstein SA, Genant HK (1994) Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int 55: 46–52

    Article  PubMed  CAS  Google Scholar 

  19. Nicholson PHF, Haddaway MJ, Davie MWJ (1994) The dependence of ultrasonic properties on orientation in human vertebral bone. Phys Med Biol 39: 1013–1024

    Article  PubMed  CAS  Google Scholar 

  20. Turner CH, Eich M (1991) Ultrasonic velocity as a predictor of strength in bovine cancellous bone. Calcif Tissue Int 49: 116–119

    Article  PubMed  CAS  Google Scholar 

  21. Hans D, Arlot ME, Schott AM, Roux JP, Kotzki PO, Meunier PJ (1995) Do ultrasound measurements on the os calcis reflect more the bone microarchitecture than the bone mass? A two-dimensional histomorphometric study. Bone 16: 295–300

    Article  PubMed  CAS  Google Scholar 

  22. Herd RJM, Blake GM, Miller CG, Parker JC, Fogelman I (1994) The ultrasonic assessment of osteopenia as defined by dual x-ray absorptiometry. Br J Radiol 67: 631–635

    PubMed  CAS  Google Scholar 

  23. Yamazaki K, Kushida K, Ohmura A, Sano M, Inoue T (1994) Ultrasound bone densitometry of the os calcis in Japanese women. Osteoporosis Int 4: 220–225

    Article  CAS  Google Scholar 

  24. Lees B, Stevenson JC (1992) Preliminary evaluation of a new ultrasound bone densitometer. Calcif Tissue Int 53: 149–152

    Article  Google Scholar 

  25. Herd RJM, Blake GM, Ramalingam T, Mille CG, Ryan PJ, Fogelman I (1993) Measurements of postmenopausal bone loss with a new contact ultrasound system. Calcif Tissue Int 53: 153–157

    Article  PubMed  CAS  Google Scholar 

  26. Ross P, Huang C, David J, Imose K, Yates J, Vogel J, Wasnich R (1995) Predicting vertebral deformity using bone densitometry at various skeletal sites and calcaneus ultrasound. Bone 16: 325–332

    Article  PubMed  CAS  Google Scholar 

  27. Stewart A, Reid DM, Porter RW (1994) Broadband ultrasound attenuation and dual energy x-ray absorptiometry in patients with hip fractures: which techniques discriminates fracture risk. Calcif Tissue Int 54: 466–469

    Article  PubMed  CAS  Google Scholar 

  28. Baran DT, Kelly AM, Karellas A, Gionet M, Price M, Leahey D, Stauterman S, McSherry B, Roche J (1988) Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif Tissue Int 43: 138–142

    Article  PubMed  CAS  Google Scholar 

  29. Porter RW, Miller CG, Grainger D, Palmer SB (1990) Prediction of hip fracture in elderly women: a prospective study. Br Med J 301: 638–641

    Article  CAS  Google Scholar 

  30. Agren M, Karellas A, Leahey D, Marks S, Baran D (1991) Ultrasound attenuation of the calcaneus: a sensitive and specific discriminator of osteopenia in postmenopausal women. Calcif Tissue Int 48: 240–244

    Article  PubMed  CAS  Google Scholar 

  31. Schott AM, Weill-Engerer S, Hans D, Duboeuf F, Delmas PD, Meunier PJ (1995) Ultrasound discriminates patients with hip fracture equally as well as dual energy x-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 10: 243–249

    Article  PubMed  CAS  Google Scholar 

  32. Turner CH, Peacock M, Timmerman L, Neal JM, Johnston CC Jr (1995) Calcaneal ultrasonic measurements discriminate hip fracture independently of bone mass. Osteoporosis Int 5: 130–135

    Article  CAS  Google Scholar 

  33. Mautalen C, Gonzalez D, Circosta AM (1993) Ultrasonic assessment of bone in normal and osteoporotic women (abstract) Presented at 4th International Symposium on Osteoporosis, Hong Kong, p 53

  34. Bouxsein ML, Courtney AC, Hayes WC (1995) Ultrasound and densitometry of the calcaneus correlate with the failure loads of cadaveric femurs. Calcif Tissue Int 56: 99–103

    Article  PubMed  CAS  Google Scholar 

  35. Blake GM, Herd RJM, Miller CG, Fogelman I (1994) Should broadband ultrasonic attenuation be normalized for the width of the calcaneus? Br J Radiol 67: 1206–1209

    Article  PubMed  CAS  Google Scholar 

  36. Kotzki PO, Buyck D, Hans D, Thomas E, Bonnel F, Favier F, Meunier PJ, Rossi M (1994) Influence of fat on ultrasound measurements of the os calcis. Calcif Tissue Int 54: 91–95

    Article  PubMed  CAS  Google Scholar 

  37. Miller CG, Herd RJM, Ramalingam T, Fogelman I, Blake GM (1993) Ultrasonic velocity measurements through the calcaneus: which velocity should be measured? Osteoporosis Int 3: 31–35

    Article  CAS  Google Scholar 

  38. Wu CY, Gluer CC, Jergas M, Bendavid E, Genant HK (1995) The impact of bone size on broadband ultrasound attenuation. Bone 16: 137–141

    Article  PubMed  CAS  Google Scholar 

  39. Hans D, Schott AM, Chapuy MC, Benamar M, Kotzki PD, Cormier C, Pouilles JM, Meunier PJ (1994) Ultrasound measurements on the os calcis in a prospective multicenter study. Calcif Tissue Int 55: 94–99

    Article  PubMed  CAS  Google Scholar 

  40. Schott AM, Hans D, Sornay E, Delmas PD, Meunier PJ (1993) Ultrasound measurements on os calcis: precision and age-related changes in a normal female population. Osteoporosis Int 3: 249–254

    Article  CAS  Google Scholar 

  41. Mazess RB (1987) Bone density in diagnosis of osteoporosis: thresholds and breakpoints. Calcif Tissue Int 41: 117–118

    Article  Google Scholar 

  42. Kawana K, Kushida K, Takahashi M, Ohishi T, Denda M, Yamazaki K, Inoue T (1994) The effect of menopause on biochemical markers and ultrasound densitometry in healthy females. Calcif Tissue Int 55: 420–425

    Article  PubMed  CAS  Google Scholar 

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Sakata, S., Kushida, K., Yamazaki, K. et al. Ultrasound bone densitometry of Os calcis in elderly Japanese women with hip fracture. Calcif Tissue Int 60, 2–7 (1997). https://doi.org/10.1007/s002239900176

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