Discrimination of proximal hip fracture by quantitative ultrasound measurement at the radius

Osteoporosis is a disease that culminates in fragility fractures and, there fore, imposes major burden on the health economy. In dealing with this worl dwide condition, it is prudent to use a reliable, inexpensive, portable dia gnostic means that does not use ionizing radiation and is capable of measur ing bone properties at several sites. Recently, a quantitative ultrasound d evice (Omnisense) that measures speed of sound (SOS) at multiple skeletal s ires was introduced. The Omnisense combines the 'axial transmission' mode a nd the critical angle concept. Preliminary reports suggested that of the di fferent skeletal sites measured by this device, the distal third of the rad ius is the preferred measurement site for osteoporosis. In this cross-secti onal study, SOS was determined at the radius using Omnisense in 50 hip-frac tured elderly women (group F, age 76.1 +/- 6.0 years), 130 elderly controls (group NF, age 71.5 +/- 5.2 years) and 185 young healthy controls (group Y H, age 40.6 +/- 3.0 years). Actual SOS was significantly lower in group F c ompared with group NF (p = 0.0001). Whereas SOS T-scores calculated for eac h woman and stratified into age subgroups within each of the study groups i ndicate decline from -2.22 to -3.56 in group F and from -1.56 to -3.17 in g roup NF, there was an increase from -0.02 to 0.03 in group YH. Age- and BMI -adjusted logistic regression for hip fracture discrimination indicated an area under the receiver operating characteristic curve for hip fracture of 0.79 (95% CI, 0.73-0.86; p = 0.005) and an odds ratio of 1.92 (95% CI, 1.22 -3.02; p = 0.005). We conclude that SOS measured at the radius by Omnisense discriminates subjects with hip fracture from controls. Prospective studie s are needed to support the role of Omnisense in assessing the risk of hip fracture.