Use of Calscan for improving osteoporosis care in the older patient admitted with hip fracture

To determine whether bone mineral density measurement using the Calscan successfully predicts the actual bone mineral density, as measured by dual-energy X-ray absorptiometry. We included all patients >= 65 years with a hip fracture screened on osteoporosis by both dual-energy X-ray absorptiometry and the Calscan during the period April 2008 to April 2011. The bone mineral density was expressed as a T-score. For the Calscan T-score, thresholds were defined such that patients with and without osteoporosis could be identified with 90% certainty. Patients with a Calscan T-score above the upper threshold were considered to be non-osteoporotic and those with a Calscan T-score below the lower threshold considered osteoporotic. Patients whose Calscan T-score lay between the two thresholds could only be classified by means of DXA. The correlation between dual-energy X-ray absorptiometry and the Calscan was 0.61. The Calscan identified approximately 25% of patients as osteoporotic and 25% as non-osteoporotic. The upper threshold was found to be -1.8SD and the lower threshold -3.5SD. Osteoporosis screening by dual-energy X-ray absorptiometry had been carried out in 44% of patients. This percentage could theoretically rise to >70% if the Calscan is implemented in osteoporosis screening, while costs of such screening appear to be lower, as long as a sufficient number of patients are screened.