Document Detail

A comparison of quantitative ultrasound of the calcaneus with dual-energy x-ray absorptiometry in hospitalized orthopaedic trauma patients.
MedLine Citation:
PMID:  20182254     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Osteoporosis remains underdiagnosed in orthopaedic trauma patients. Recently, protocols have emerged to identify and treat osteoporosis in this population. Our purpose was to compare the usefulness of quantitative ultrasound of calcaneus (QUS) with dual-energy x-ray absorptiometry (DXA) for identifying orthopaedic trauma patients at risk for osteoporotic fractures. DESIGN: A retrospective review of an osteoporosis screening protocol comparing QUS and DXA. SETTING: Regional trauma center. PATIENTS: Three hundred sixty consecutive hospitalized orthopaedic trauma patients treated by a single surgeon. INTERVENTION: QUS T-score and DXA bone mineral density T-scores (hip or radius) were obtained relative to U.S. normative data. MAIN OUTCOME MEASUREMENTS: QUS and DXA data were statistically compared to analyze their relationship. Potential thresholds for osteoporosis risk were subsequently defined. RESULTS: Testing was successfully performed with heel QUS in 350 patients and with DXA in 129 patients. One hundred twenty-six patients underwent testing with both modalities. According to World Health Organization criteria, 17% of patients tested with DXA had osteoporosis. A good predictive relationship between hip bone mineral density, as estimated by calcaneal QUS, and direct DXA measurement was seen (Pearson's r correlation coefficient of 0.53; area under the curve of 0.84 with 95% confidence interval=0.75-0.90; P=0.0001). QUS T-score cutoffs of greater than -0.9 resulted in 90% sensitivity (defining low osteoporosis risk) and a threshold of -1.6 or less resulted in a specificity of 80% (defining high osteoporosis risk). CONCLUSIONS: Substantial logistical difficulties are inherent in attempting to obtain DXA scans in orthopaedic trauma patients at our regional trauma center. For those patients who did undergo DXA, a strong predictive relationship was seen between hip bone mineral density and QUS parameters. QUS thresholds in defining low- and high-risk subjects for osteoporosis in this population using this device are proposed. QUS is a simple, reliable, and relatively inexpensive tool for evaluating osteoporosis risk in orthopaedic trauma patients.
Cory A Collinge; George Lebus; Michael J Gardner; Laura Gehrig
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  24     ISSN:  1531-2291     ISO Abbreviation:  J Orthop Trauma     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-25     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  176-80     Citation Subset:  IM    
Department of Orthopaedic Trauma, Harris Methodist Fort Worth Hospital John Peter Smith Orthopaedic Surgery Residency Program, Fort Worth, TX 76104, USA.
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MeSH Terms
Absorptiometry, Photon / methods*
Aged, 80 and over
Bone Density / physiology*
Calcaneus / metabolism*,  radiography,  ultrasonography
Mass Screening / methods*
Middle Aged
Osteoporosis / diagnosis*,  metabolism
Prospective Studies
Trauma Centers
Ultrasonography / methods*
Young Adult

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