Endocrinology · 5 h ago
REMS and DXA show limited agreement after hip fracture
In a prospective observational study of 86 older patients after hip fracture surgery, radiofrequency echographic multispectrometry (REMS) measurements were compared with DXA on postoperative day 7. REMS correlated moderately with DXA but systematically gave lower BMD values, with wide limits of agreement; the authors say it should be considered complementary rather than interchangeable.
- REMS and DXA had moderate correlations at both sites.
- REMS systematically produced lower BMD values than DXA.
- Wide limits of agreement argue against interchangeability.
- Study measurements were taken on postoperative day 7.
This prospective observational study enrolled 86 patients aged 50 years or older who underwent hip fracture surgery at a hospital in Nagoya, Japan, from October to December 2025. DXA and ultrasound-based REMS were performed on postoperative day 7. Analyses included 51 patients for lumbar spine measurements and 76 for femoral neck measurements.
REMS and DXA BMD were moderately correlated at the lumbar spine (r=0.673) and femoral neck (r=0.636; both p<0.001). REMS values were significantly lower, with mean differences of −0.080 g/cm² at the spine and −0.037 g/cm² at the femoral neck. Limits of agreement were wide, and proportional bias was negative at both sites. Agreement in T-score categories was limited despite high crude agreement at the femoral neck. REMS added explanatory value for DXA BMD at the spine, but not at the femoral neck.
The findings do not support using REMS values as direct substitutes for DXA in the acute postoperative setting. The single-centre study had site-specific analysis populations and evaluated measurements at one postoperative time point. The EchoS system was provided on loan by Toyo Medic; the authors report that the company had no role in the study.
In practice
For older adults assessed during the acute postoperative phase after hip fracture, these data indicate that REMS BMD should not be substituted directly for DXA: REMS values were systematically lower and showed wide limits of agreement, despite moderate correlations. REMS may have a complementary role, but this single-centre study assessed measurements only on postoperative day 7 and does not establish diagnostic equivalence or performance beyond this setting.
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Osteoporosis International: Agreement between radiofrequency echographic multispectrometry and dual-energy X-ray absorptiometry for assessing bone mineral density in older patients during the acute phase following hip fracture ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.