Clinical Significance of Discordance between Hip and Spine Bone Mineral Density in Korean Elderly Patients with Hip Fractures

The clinical significance of BMD discordance has not yet been elucidated. The objective of this study was to evaluate the clinical significance of BMD discordance between the hip and spine for hip fractures. The BMD was measured and related factors were investigated in 109 elderly patients hospitalized for a hip fracture (fracture group) and 109 patients hospitalized without a hip fracture (non-fracture group). BMD discordance of the hip and spine was classified as minor discordance (normal and osteopenia, and osteopenia and osteoporosis) and major discordance (normal and osteoporosis). The risk of hip fracture was calculated according to the type of discordance: no discordance, low hip, and lower spine. There was no significant difference between the general characteristics of the fracture group and the non-fracture group. The rate of BMD discordance and low hip discordance were significantly higher in the fracture group (53.2%, 43.1%) than in the non-fracture group (28.4%, 19.3%). The odds ratio of hip fracture was 2.86 times higher in patients with BMD discordance than in those without discordance and 3.42 times higher in the patients with low hip discordance than in those without no hip discordance. The presence of discordance, particularly when there is low hip discordance, might be related to the hip fractures.

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