The hip fracture incidence curve is shifting to the right: A forecast of the age-quake

Background The number of hip fractures has doubled in the last 30–40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups

Metastatic lung cancer detected by lumbar bone densitometry - A case report

A lumbar bone densitometry examination was performed in a patient with severe low back pain but no pathologic findings on initial laboratory and radiologic investigations. The bone mineral density of the spine was in the low-normal range (90.5% age matched), with the L4 vertebra bone mineral density less than the others, whereas image analysis showed a defect in the right part of its body. Additional radiographs confirmed this finding, which was proved to be a metastatic lesion from a primary lung cancer. Although not intended for diagnosis, the results of image analysis of bone densitometry should be evaluated carefully

Association of physical exercise and calcium intake with bone mass measured by quantitative ultrasound

Background: Interventions other than medications in the management of osteoporosis are often overlooked. The purpose of this study was to investigate the association of physical activity and calcium intake with bone parameters.Methods: We measured the heel T-score and stiffness index (SI) in 1890 pre- and postmenopausal women by quantitative ultrasound (QUS) and assessed physical activity and dietary calcium intake by questionnaire. Participants were divided according to their weekly physical activity (sedentary, moderately active, systematically active) and daily calcium consumption (greater than or less than 800 mg/day).Results: SI values were significantly different among premenopausal groups (p = 0.016) and between sedentary and systematically active postmenopausal women (p = 0.039). QUS T-scores in systematically active premenopausal women with daily calcium intake > 800 mg/day were significantly higher than those in all other activity groups (p < 0.05) independent of calcium consumption.Conclusions: Systematic physical activity and adequate dietary calcium intake are indicated for women as a means to maximize bone status benefits. © 2010 Dionyssiotis et al; licensee BioMed Central Ltd

Pain relief from nasal salmon calcitonin in osteoporotic vertebral crush fractures - A double blind, placebo-controlled clinical study

We examined the analgesic effect of nasal salmon calcitonin in patients with acute pain due to recent, nontraumatic osteoporotic vertebral crush fractures. 32 men and 68 postmenopausal women were studied using a prospective, double-blind, placebo-controlled clinical design. Men and women taking 200 IU of nasal salmon calcitonin daily for a period of 28 days had a dramatic decrease of spinal pain. This analgesic effect was accompanied by early mobilization and gradual restoration of the locomotor functions, such as sitting, standing and walking. Patients receiving the placebo nasal spray remained in bed for almost the entire period of observation. The consumption of high doses of paracetamol did not help placebo patients to get out of bed during the 4 weeks of hospitalization. Nasal salmon calcitonin and early mobilization also reduced hydroxyproline excretion, thus preventing massive bone loss during the period of bedrest

Effect of rhythmic gymnastics on volumetric bone mineral density and bone geometry in premenarcheal female athletes and controls

Context and Objective: Weight-bearing exercise during growth exerts positive effects on the skeleton. Our objective was to test the hypothesis that long-term elite rhythmic gymnastics exerts positive effects on volumetric bone mineral density and geometry and to determine whether exercise-induced bone adaptation is associated with increased periosteal bone formation or medullary contraction using tibial peripheral quantitative computed tomography and bone turnover markers. Design and Setting: We conducted a cross-sectional study at a tertiary center. Subjects: We studied 26 elite premenarcheal female rhythmic gymnasts (RG) and 23 female controls, aged 9-13 yr. Main Outcome Measures: We measured bone age, volumetric bone mineral density, bone mineral content (BMC), cortical thickness, cortical and trabecular area, and polar stress strength index (SSIp) by peripheral quantitative computed tomography of the left tibia proximal to the distal metaphysis (trabecular) at 14, 38 (cortical), and 66% (muscle mass) from the distal end and bone turnover markers. Results: The two groups were comparable according to height and chronological and bone age. After weight adjustment, cortical BMC, area, and thickness at 38% were significantly higher in RG (P < 0.005-0.001). Periosteal circumference, SSIp, and muscle area were higher in RG (P < 0.01-0.001). Muscle area was significantly associated with cortical BMC, area, and SSIp, whereas years of training showed positive association with cortical BMC, area, and thickness independent of chronological age. Conclusions: RG in premenarcheal girls may induce positive adaptations on the skeleton, especially in cortical bone. Increased duration of exercise is associated with a positive response of bone geometry. Copyright © 2010 by The Endocrine Society

Incidence and direct hospitalisation costs of hip fractures in Vilnius, capital of Lithuania, in 2010

<p>Abstract</p> <p>Background</p> <p>Few epidemiological data on hip fractures were previously available in Lithuania. The aim of this study was to estimate the incidence and hospital costs of hip fractures in Vilnius in 2010.</p> <p>Methods</p> <p>Data were collected from the medical charts of all patients admitted to hospitals in Vilnius (population, 548,835) due to new low-energy trauma hip fracture, during 2010. The estimated costs included ambulance transportation and continuous hospitalisation immediately after a fracture, which are covered by the Lithuanian healthcare system.</p> <p>Results</p> <p>The incidence of new low-energy trauma hip fractures was 252 (308 women and 160 men) per 100,000 inhabitants of Vilnius aged 50-years or more. There was an exponential increase in the incidence with increasing age. The overall estimated cost of hip fractures in Vilnius was 1,114,292 EUR for the year 2010. The greatest part of the expenditure was accounted for by fractures in individuals aged 65-years and over. The mean cost per case was 2,526.74 EUR, and cost varied depending on the treatment type. Hip replacement did not affect the overall mean costs of hip fracture. The majority of costs were incurred for acute (53%) and long-term care (35%) hospital stays, while medical rehabilitation accounted for only 12% of the overall cost. The costs of hip fracture were somewhat lower than those found in other European countries.</p> <p>Conclusion</p> <p>The data on incidence and costs of hip fractures will help to assess the importance of interventions to reduce the number of fractures and associated costs.</p

A systematic review of hip fracture incidence and probability of fracture worldwide

Summary: the country-specific risk of hip fracture and the 10-year probability of a major osteoporotic fracture were determined on a worldwide basis from a systematic review of literature. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.Introduction: the present study aimed to update the available information base available on the heterogeneity in the risk of hip fracture on a worldwide basis. An additional aim was to document variations in major fracture probability as determined from the available FRAX models.Methods: studies on hip fracture risk were identified from 1950 to November 2011 by a Medline OVID search. Evaluable studies in each country were reviewed for quality and representativeness and a study (studies) chosen to represent that country. Age-specific incidence rates were age-standardised to the world population in 2010 in men, women and both sexes combined. The 10-year probability of a major osteoporotic fracture for a specific clinical scenario was computed in those countries for which a FRAX model was available.Results: following quality evaluation, age-standardised rates of hip fracture were available for 63 countries and 45 FRAX models available in 40 countries to determine fracture probability. There was a greater than 10-fold variation in hip fracture risk and fracture probability between countries.Conclusions: worldwide, there are marked variations in hip fracture rates and in the 10-year probability of major osteoporotic fractures. The variation is sufficiently large that these cannot be explained by the often multiple sources of error in the ascertainment of cases or the catchment population. Understanding the reasons for this heterogeneity may lead to global strategies for the prevention of fracture