Proximal femur bone density measurements consistently outperform lumbar spine measurements for global fracture prediction, Canadian researchers report in the August 13/27th issue of the Archives of Internal Medicine. Proximal femur bone density measurements consistently outperform lumbar spine measurements for global fracture prediction, Canadian researchers report in the August 13/27th issue of the Archives of Internal Medicine.

"Bone density measurements from different sites in the body often disagree," lead investigator Dr. William D. Leslie told Reuters Health. "This has been confusing to physicians trying to assess a patient's risk for fracture."

"To date," he added, "there has been relatively little emphasis on the total hip measurement since it only came into clinical use in the late 1990s."

To investigate which measurements might be most effective in fracture prediction, Dr. Leslie of the University of Manitoba, Winnipeg and colleagues used a database from that province to study information on 16,505 women aged 50 years or more at the time of undergoing dual-energy x-ray absorptiometry of the spine and hip.

After a mean observation period of 3.2 years, the team found that age-adjusted hazard ratios per standard deviation for osteoporotic fracture ranged from 1.61 for the lumbar spine to 1.85 for the total hip. There were intermediate values for the femur neck (hazard ratio, 1.76) and the trochanter (hazard ratio, 1.77).

The investigators also found that minimum bone density measurement was no better than use of a hip measurement alone in predicting fracture risk. Furthermore, when the total hip measurement was included in a fracture prediction model for the overall population, none of the other measurements added substantial information.

Dr. Leslie concluded, "Our study highlights the importance of the total hip region as the measurement site that is most strongly predictive of fractures.