This prospective study evaluated the agreement between REMS and DXA in older patients after hip fracture. REMS showed moderate correlation with DXA but limited absolute agreement, with systematically lower BMD values. REMS may serve as a complementary tool rather than a direct substitute for DXA. Radiofrequency echographic multispectrometry (REMS) is an ultrasound-based technique for assessing bone status; however, its performance after hip fracture remains unclear. This study evaluated the agreement between REMS and dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) assessment during the acute postoperative phase. This prospective observational study enrolled consecutive patients aged ≥50 who underwent hip fracture surgery between October 1 and December 31, 2025. DXA and REMS were performed sequentially on postoperative day 7. Lumbar spine and femoral neck BMD were compared using correlation, Bland-Altman analysis, and paired testing. Exploratory analyses used age/weight-adjusted hierarchical regression. Among 86 enrolled patients, 51 were eligible for lumbar spine analysis and 76 for femoral neck analysis. REMS-BMD correlated moderately with DXA-BMD at the lumbar spine (r = 0.673) and femoral neck (r = 0.636; both p < 0.001). Mean bias was −0.080 g/cm² at the lumbar spine and −0.037 g/cm² at the femoral neck, with wide limits of agreement and negative proportional bias at both sites. REMS values were significantly lower than DXA values. REMS-BMD explained additional variance in DXA-BMD at the lumbar spine (ΔR² = 0.0778, p = 0.011), but not at the femoral neck (ΔR² = 0.0044, p = 0.465). T-score category agreement was limited despite high crude agreement at the femoral neck. REMS demonstrated moderate correlation but limited absolute agreement with DXA. It may be useful as a complementary tool after a hip fracture, but its values should not be considered directly interchangeable with DXA.
Improved survival in cystic fibrosis (CF) has increased the burden of cystic fibrosis–related bone disease (CFBD), yet the natural history of bone mineral density (BMD) decline remains poorly defined. We conducted a systematic review and meta-analysis (PROSPERO: CRD420251091118) to quantify longitudinal BMD changes in adults with CF. MEDLINE, Embase, Cochrane, and PubMed were searched through March 22, 2025 for observational studies and control arms of randomized trials reporting ≥2 dual-energy X-ray absorptiometry (DXA) scans ≥1 year apart in adults not receiving osteoporosis therapy; post–lung transplant DXAs were excluded. The primary outcome was annual percent change in BMD at the lumbar spine (LS) and femoral neck (FN). Random-effects models were used; heterogeneity was assessed with I². Twelve studies (n = 811; mean age 21–31 years; mean follow-up 24 months) were included, with 10 contributing to meta-analysis. Pooled annual BMD change was –0.28
The prognosis of hip fracture in younger adults (YAs) aged 18–50 years is unestablished. Large studies that rigorously assess risk factors for hip fracture in YAs, their associated functional outcomes and mortality are lacking. While international guidelines recommend comprehensive bone health assessment and consideration of pharmacotherapy in YAs with major fragility fractures, rates of implementation of these guidelines are unknown. We systematically reviewed the existing literature on YAs with hip fracture to identify (1) clinical risk factors for hip fracture, (2) functional outcomes beyond 12 months from hip fracture (including employment and mortality) and (3) referral rates for bone health assessment. Forty-four studies were included from 1875 eligible abstracts. Twenty-three studies reported data on question 1. Psychiatric disease (15
Achieving 7000 steps/day on ≥3 days/week significantly reduced the risk of decline in quantitative ultrasound measurements in premenopausal women, but not in postmenopausal women. Less frequent achievement (1–2 days/week) showed no significant association in either group. To examine the association between the frequency of achieving the recommended daily step count (7000 steps/day) and the incidence of a decline in quantitative ultrasound (QUS) measurements among pre- and postmenopausal women. In this prospective cohort study of the Tohoku Medical Megabank Community-Based Cohort, baseline and follow-up surveys were conducted between 2013–2016 and 2017–2021 (mean follow-up: 42.5 months). Participants were 3529 women (1013 premenopausal, 2516 postmenopausal). Daily steps were objectively measured using pedometers. The number of days per week achieving 7000 steps was categorized as Inactive (0 days), Low active (1–2 days), and Active (≥3 days). The outcome was the incidence of a decline in QUS measurements, defined as a QUS T-score ≤–2.5 or a self-reported diagnosis of osteoporosis. Adjusted risk ratio (RR) and 95
