Handgrip strength and 25OHD decrease with aging in postmenopausal women. The patients with lower 25OHD level had significantly lower BMD of femoral neck. The patients with lower handgrip strength had significantly lower BMD of lumbar spine, femoral neck, and total hip. Grip strength measurement is the simplest muscle strength measurement method. Our study confirmed that low grip strength was correlated with low BMD and was a strong risk factor for osteoporosis in postmenopausal women.

BackgroundVertebral fracture is the most common fragility fracture but it remains frequently unrecognized and is underdiagnosed worldwide. In this retrospective study, we examined the prevalence of moderate and severe vertebral fractures on chest radiographs of hospitalized female patients aged 50 years and older and determined missed diagnosis of vertebral fractures in the original radiology reports.Methods3216 female patients 50 years of age and older were enrolled in our study. The patients’ medical records including their original radiology reports and lateral chest radiographs were retrospectively reviewed by the study radiologists who had training certificates from the International Society for Clinical Densitometry (ISCD). Vertebral fractures between thoracic spine T4 and lumbar spine L1 were identified and classified using Genant’s semi-quantitative scale. The definition of vertebral fractures used in this study was Genant grade 2 or higher.ResultsThe study radiologists identified 295(9.2%) patients with grade 2 or 3 fractured vertebrae, total 444 vertebrae on 3216 chest radiographs. The prevalence of vertebral fracture was 2.4% in women aged 50-59 yrs., 8.9% in women aged 60–69 yrs., and 21.9% in women aged≥70 yrs. There were 213 patients with a single vertebral fracture, 49 patients with two vertebral fractures and 33 patients with ≥ three vertebral fractures. Fractured vertebrae were identified with greater frequency in thoracic spine T11,12 and lumbar spine L1. According to our statistics, 66.8% of patients with vertebral fractures found in this study were undiagnosed in the original radiology reports.ConclusionsVertebral fracture is common on chest radiographs but it is often ignored by radiologists. Genant’s semiquantitative assessment is a simple and effective method for detecting vertebral fracture. Because osteoporotic vertebral fracture increases the risk of new fractures, radiologists have an important role in accurately diagnosing vertebral fractures.

The aim of this study was to assess the influence of bone mineral density and hip geometry on the fragility fracture of femoral neck and trochanteric region. There were 95 menopausal females of age ≥ 50 years with fragility fracture of hip, including 55 cases of femoral neck fracture and 40 cases of trochanteric fracture. Another 63 non-fractured females with normal bone mineral density (BMD) were chosen as control. BMD, hip axis length, neck-shaft angle and structural parameters including cross surface area, cortical thickness and buckling ratio were detected and compared. Compared with control group, the patients with femoral neck fracture or trochanteric fractures had significantly lower BMD of femoral neck, as well as lower cross surface area and cortical thickness and higher buckling ratio in femoral neck and trochanteric region. There were no significant differences of BMD and structural parameters in the femoral neck fracture group and intertrochanteric fracture group. Hip axis length and neck-shaft angle were not significantly different among three groups. The significant changes of BMD and proximal femur geometry were present in the fragility fracture of femoral neck and trochanteric region. The different types of hip fractures cannot be explained by these changes.

Significant gaps exist in hip fracture management in the Beijing hospital compared with the best practice achieved in 180 UK hospitals, highlighting the need to implement and evaluate proactive strategies to increase the uptake of best practice hip fracture care in China.