Hip fracture patients have generalized osteopenia with a preferential deficit in the femur

Bone density was measured in 31 white women with hip fractures by single- and dual-photon absorptiometry at the radius, lumbar spine and proximal femur. The mean age was 71.4 years. Comparison with premenopausal normals revealed Z-scores as follows: radius, -1.75; spine, -1.45; femoral neck, -2.40; Ward's triangle, -2.41; and trochanter, -1.42. These values altered when calculated for the patient's age by the use of sex- and race-specific regressions against age in a healthy, non-fracture population. The age-corrected Z-scores were as follows: radius, -0.09; spine, -0.18; femoral neck, -0.79; Ward's triangle, -0.44; and trochanter, -0.80. Thus, although our patients had absolute osteopenia at all skeletal sites when compared with young normals, when compared with age-matched normals (relative osteopenia) the only site with a noticeable deficit was the femur. Interpretation of the extent of osteopenia by comparison with young normals may lead to different conclusions than when an age-matched population is used. Patients with hip fractures had a preferential deficit in density of the femur when compared with normal women of their age.