Proximal femur bone density measurements consistently outperformed lumbar spine measurements for fracture prediction, according to study results published in the August issue of the Archives of Internal Medicine.

Researchers at the University of Manitoba, in Winnipeg, Canada and the Manitoba Bone Density Program examined 16,505 women, aged 50 and older, at the time of baseline dual-energy x-ray absorptiometry of the spine and hip. Each subject's longitudinal health service record was assessed for the presence of fracture codes after bone density testing and the observation periods lasted between 1.5 and 3.2 years.

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, with intermediate values for the femur, neck and trochanter.

The study determined that for fracture prediction, the use of the minimum bone density measurement was no better than use of a hip measurement alone. When the total hip measurement was included in a fracture prediction model for the overall population, none of the other measurements added substantial information.

According to the results, the spine was the most useful site for the prediction of spine fractures alone.