Discriminative ability of calcaneal quantitative ultrasound compared with dual-energy X-ray absorptiometry in men with hip or distal forearm fractures

Abstract

Objectives: The aim of this caseecontrol study was to compare the discriminatory ability of bone mineraldensity (BMD) measurements and calcaneal quantitative ultrasound (QUS) parameters for fractures andto determine fracture thresholds for each variable in men with hip or distal forearm fractures.Patients and methods: A total of 20 men with hip and 18 men with distal forearm fractures and 38 agematched controls were included in this study. Dual-energy X-ray absorptiometry (DXA) BMD (spine andhip) and calcaneal QUS measurements were made. Area under the curves (AUCs) were calculated toassess 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 bestparameters for the identiŞcation of hip and distal forearm fractures, respectively, with AUCs greater thanthose of DXA BMD and other QUS parameters. While a QUI T-score of 1.18 could identify and rule outhip fracture cases with approximately 80% sensitivity and speciŞcity, a SOS value of 1529.75 reached toalmost 90% for ruling in and out distal forearm fractures.Conclusion: The discriminatory performance of calcaneal QUS variables between fractured and nonfractured men was as good as those of the DXA BMD and even better. Since men appear to sustainfractures at closer QUS variable levels than those of the DXA BMD regardless of the fracture type, it maybe speculated that calcaneal QUS may be more helpful in predicting the risk of fractures when BMD alonedoes not demonstrate impaired bones.Level of Evidence: Level III, Study of Diagnostic Test© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).