Quantitative Heel Ultrasonography, 25‐Hydroxyvitamin D, and Urine Amino‐terminal Cross‐linking Telopeptide of Type I Collagen in Patients With a Recent Hip Fracture

Objective. This study examined quantitative heel ultrasonography (QUS), 25‐hydroxyvitamin D (25‐OHD) levels, and urine amino‐terminal cross‐linking telopeptide of type I collagen (NTX‐I) levels in patients with a recent osteoporotic hip fracture to see whether they were clinically useful. Methods. Stiffness index (SI) T scores from QUS, 25‐OHD levels, and urine NTX‐I levels were obtained in 53 female and 32 male patients with hip fractures. Sixty‐five female patients and 5 male patients attending our geriatric clinic were used for comparison. Results. The SI T scores of the hip fracture patients were less than those of the geriatric clinic patients. The difference was significant in female patients ( P = .0001) but not in male patients ( P = .1). Serum levels of 25‐OHD were less than 28 ng/mL in 50 of 59 patients and less than 5 ng/mL in 2 patients. Levels of urine NTX‐I were variable and were not correlated with other parameters. Conclusions. Patients who have had a hip fracture have a low SI determined by QUS; this is easy to perform, and it provides a baseline T score from which to assess treatment effects. Most of these patients are vitamin D deficient, and measurement of the 25‐OHD level would enable physicians to prescribe an appropriate dose of vitamin D. Urine NTX‐I measured shortly after a hip fracture is not clinically helpful.