Open Access Research article

Association between low-frequency ultrasound and hip fractures - comparison with DXA-based BMD

Mikko Määttä12*, Petro Moilanen3, Jussi Timonen3, Pasi Pulkkinen1, Raija Korpelainen1456 and Timo Jämsä167

Author Affiliations

1 Department of Medical Technology, University of Oulu, Institute of Biomedicine, PO Box 5000, FI-90014 Oulu, Finland

2 Infotech Oulu, University of Oulu, Oulu, Finland

3 Department of Physics, University of Jyväskylä, Jyväskylä, Finland

4 Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland

5 Institute of Health Sciences, University of Oulu, Oulu, Finland

6 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

7 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland

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BMC Musculoskeletal Disorders 2014, 15:208  doi:10.1186/1471-2474-15-208

Published: 16 June 2014



New methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women.


The study population consisted of 490 community-dwelling women (78–82 years). Ultrasound velocity (VLF) at mid-tibia was measured in 2006 using a low-frequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997.


During the total follow-up period (1997–2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low VLF (the lowest quartile) was associated with increased hip fracture risk when compared with VLF in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, VLF was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0).


Low VLF was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors. Further development of the method is needed to improve the measurement precision and to confirm the results.

Quantitative ultrasound; Speed of sound; Osteoporosis; Hip fracture; Cortical bone