Hip and femur trump spine for predicting fractures

Bone density measurements with dual-energy x-ray absorptiometry of the proximal femur consistently outperform those of the lumbar spine for predicting global fracture risk in postmenopausal women, according to the results of a Canadian historical cohort study.

Researchers from Manitoba included in the study over 16,000 women 50 years of age and older. They calculated age-adjusted hazard ratios (HRs) per standard deviation for osteoporotic fracture of 1.61 (95% CI, 1.39–1.87) for the lumbar spine, 1.76 (95% CI, 1.62–1.92) for the femur neck, 1.77 (95% CI, 1.63–1.92) for the trochanter, and 1.85 (95% CI, 1.70–2.01) for the total hip.

While the spine was the most useful site for predicting spine fractures alone, total hip measurement was the most useful for global fracture prediction in the overall population, and no other measurement added substantial information.