Changes over time in hip fracture risk: Greater improvements in men compared to women.

PURPOSE: The aim of this study was to determine whether there has been a change in the mean age and age-standardized incidence of minimal trauma hip fractures in the Newcastle and Lake Macquarie population of Australia between 1998 and 2015. METHOD: Patients with neck of femur fractures over 50 who presented to the regional referral centre were retrospectively identified using the ICD-9 and ICD-10 coding system. RESULTS: There were 233 and 308 eligible patients in 1998 and 2015, respectively. For females, the mean age for hip fracture of 83.2 years in 1998 was not significantly different from the mean age of 84.5 years in 2015 (P = .16). For males, the mean age for hip fracture was significantly older at 84.6 years in 2015 compared to 80.4 years in 1998 (P = .005). For females, the decrease in the rate of hip fracture from 1998 to 2015 was 13% and was weakly statistically significant (IRR = 0.86, P = .05). For males, there was a statistically significant decrease in the rate of hip fractures from 1998 to 2015 by 33% (IRR = 0.67, P = .001). CONCLUSION: Our study shows a decrease in age-standardized rates of hip fractures for men and women and suggests that men are demonstrating a greater improvement in bone health compared to women.

Refractory hyperparathyroidism with a T3 bony lesion-differential diagnoses.

We report a case of severe hyperparathyroidism complicated by osteitis fibrosa cystica in an 83-year-old man post-myocardial infarction. The lesions were evident on magnetic resonance imaging only. A diagnosis of parathyroid carcinoma was considered due to clinical appearance of the parathyroid intraoperatively and the presence of an invasive T3 lesion mimicking metastatic disease. Differentiating parathyroid carcinoma from the benign causes at presentation can be difficult due to overlapping clinical, biochemical, radiological and histological features. The presence of bony lesions increases the diagnostic complexity of the case and demonstrates the challenges involved in the management of this disorder.