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Quantitative heel ultrasound as a predictor for osteoporosis
Author(s) -
Naganathan Vasi,
March Lyn,
Hunter David,
Markovey Joanna,
Sambrook Philip N,
Pocock Nick A
Publication year - 1999
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1999.tb123659.x
Subject(s) - osteoporosis , medicine , calcaneus , heel , bone mineral , osteopenia , physical therapy , rheumatology , nuclear medicine , surgery , anatomy
Objective To determine the diagnostic value of quantitative ultrasound (QUS) to predict bone mineral density (BMD) categories as defined by dual‐energy x‐ray absorptiometry. Design Cross‐sectional survey. Setting Rheumatology department of a tertiary care hospital (Royal North Shore Hospital, Sydney, NSW), 1997–1998. Subjects 326 healthy women aged 45–80 years who had volunteered for a twin study. Our study included both members of non‐identical twin pairs but only one randomly selected member of identical twin pairs. Main outcome measures BMD categories as defined by dual‐energy x‐ray absorptiometry of lumbar spine and left hip, and QUS of calcaneus; sensitivity, specificity and likelihood ratios (LRs) of QUS parameters to diagnose osteoporosis as defined by BMD. Results The sensitivity of QUS to diagnose BMD osteoporosis varied between 9% and 47%, depending on the QUS parameter. The specificity of QUS was high (88%–100%). If all QUS parameters were normal, osteoporosis was unlikely (LR, 0–0.2). One QUS parameter, broadband ultrasound attenuation (BUA), was highly predictive of osteoporosis by BMD when in the osteoporotic range (LR, ∞), but had low sensitivity (9%). QUS results in the osteoporotic range for other parameters and all QUS results in the osteopenic range were less predictive (LR, 1.0–5.2) of osteoporotic BMD. Conclusion These results suggest that, for most of those tested for osteoporosis by QUS in the community, uncertainty remains about expected BMD.