It can be concluded that QUS variables, particularly BUA, and FRAX® major osteoporotic fracture probability without BMD are good candidates for the identification of both hip and distal forearm fractures.

ObjectivesThe aim of this case–control study was to compare the discriminatory ability of bone mineral density (BMD) measurements and calcaneal quantitative ultrasound (QUS) parameters for fractures and to determine fracture thresholds for each variable in men with hip or distal forearm fractures.Patients and methodsA total of 20 men with hip and 18 men with distal forearm fractures and 38 age-matched controls were included in this study. Dual-energy X-ray absorptiometry (DXA) BMD (spine and hip) and calcaneal QUS measurements were made. Area under the curves (AUCs) were calculated to assess fracture discriminatory power of DXA and QUS variables.ResultsQuantitative Ultrasound Index (QUI) T-score and Speed of Sound (SOS) were found to be the best parameters for the identification of hip and distal forearm fractures, respectively, with AUCs greater than those of DXA BMD and other QUS parameters. While a QUI T-score of ≤−1.18 could identify and rule out hip fracture cases with approximately 80% sensitivity and specificity, a SOS value of ≤1529.75 reached to almost 90% for ruling in and out distal forearm fractures.ConclusionThe discriminatory performance of calcaneal QUS variables between fractured and non-fractured men was as good as those of the DXA BMD and even better. Since men appear to sustain fractures at closer QUS variable levels than those of the DXA BMD regardless of the fracture type, it may be speculated that calcaneal QUS may be more helpful in predicting the risk of fractures when BMD alone does not demonstrate impaired bones.Level of Evidence: Level III, Study of Diagnostic Test

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ÖZET AMAÇ: Gonartroz, ağrı ve sertliğe neden olan kronik, dejeneratif bir hastalıktır. Konservatif ve cerrahi olarak tanımlanan birçok tedavi yöntemi vardır. Eklem içi hiyaluronik asit enjeksiyonu bu yöntemlerden biridir. Tedavide rutin olarak kullanılan farklı preparatlar vardır ve hangisinin daha etkili olduğuna dair net bir kanıt yok. Farklı molekül ağırlıklarına sahip HA preparatlarının gonartrozu olan hastaların ağrı ve işlevselliği üzerine etkilerini araştırmayı amaçladık. GEREÇ VE YÖNTEM: İki taraflı gonartroz tanısı konan 55 hastanın 30'u (40-80 yaşları arasında) çalışmaya alındı. Hastalar rastgele 3 gruba ayrıldı (Hyalgan (N = 10), Ortez (N = 10), Synvisc (N = 10)). Hastalar tedaviden önce ve sonra değerlendirildi. Klinik muayene, Görsel Analog Skala, WOMAC skoru, sertlik ve fiziksel durum, 15 m yürüme süresi ve 15 basamak yukarı ve aşağı performans değerlendirildi. . BULGULAR: Gruplar arasında yaş, vücut kitle indeksi (BKİ) ve semptom süresi açısından anlamlı fark yoktu (sırasıyla p: 0.917, p: 0.721, p: 0.519). Her üç grupta da tedavi öncesi VAS skorları (hareket, dinlenme ve gece) tedaviden sonra anlamlı olarak azaldı (p=0.001). WOMAC sonuçlarına göre tedaviden sonra ağrı, sertlik belirgin olarak azaldı (p=0.001). Herhangi bir parametrede gruplar arasında anlamlı fark bulunmadı (p=0.05). SONUÇ: Bu çalışmanın sonuçları, WOMAC ve VAS skorlarındaki HA preparatları arasında istatistiksel olarak anlamlı bir fark olmadığını ortaya koydu; Bununla birlikte, HA'nın etkili olduğu ve erken evre gonartroz tedavisinde kullanılması gerektiği bulunmuştur.. ABSTRACTOBJECTIVE: Gonarthrosis is a chronic, degenerative disease that causes pain and stiffness. There are many treatment methods defined as conservative and surgical. Intra-articular hyaluronic acid injection is one of these methods. There are different preparations routinely used in the treatment. There is no clear evidence of which is more effective. We aimed to investigate the effectiveness of HA preparations with different molecular weights on pain and functionality of patients with gonarthrosis. MATERIALS AND METHODS: 30 of 45 patients (ranging 40-80 years old) diagnosed as bilateral gonarthrosis were enrolled in the study. Patients were randomly divided into 3 groups (Hyalgan (N = 10), Orthovics (N = 10), Synvisc (N = 10)). Patients were evaluated before and after treatment. Clinical examination, Visual Analogue Scale, WOMAC score, stiffness and physical condition, 15 m walking time and 15 steps up and down performance were evaluated. (p: 0.917, p: 0.721, p: 0.519, respectively). In all three groups, pre-treatment VAS scores (motion, rest and night) significantly decreased after treatment (p <0.001). According to WOMAC results, pain, stiffness decreased significantly after treatment (p <0.001). There was no significant difference between the groups in any parameter (p> 0.05).. RESULTS: There was no significant difference between the groups in terms of age, body mass index (BMI) and symptom duration CONCLUSION:The results of this study revealed no statisti...