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Potential roles for quantitative ultrasound in the management of osteoporosis
Author(s) -
Pocock Nicholas A,
Culton Nicole L,
Hoy Melanie L,
Freund Judith,
GIibert Guerlaln R,
Chu John M,
Bablcheva Rosalie,
Lee Klan S
Publication year - 2000
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.1326-5377.2000.tb125686.x
Subject(s) - osteoporosis , medicine , osteoporotic fracture , physical therapy , lumbar spine , dual energy , risk factor , ultrasound , bone mineral , radiology , surgery
Objective To assess the validity of four models for the role of quantitative ultrasound (QUS) in the management of osteoporosis. Design Cross‐sectional survey and review of literature. Settings Nuclear medicine departments of three teaching hospitals in Sydney. Subjects 1000 women aged 22 to 88 years (mean, 59 years) referred for assessment of osteoporotic fracture risk. Main outcome measures BMD categories as defined by dual‐energy x‐ray absorptiometry (DEXA) of the lumbar spine and proximal femur, and QUS category as defined by calcaneal ultrasound stiffness; prevalence of DEXA defined osteoporosis in the different QUS categories. Results In women with QUS Achilles stiffness ≤ 70 the prevalence of axial osteoporosis was 51%, whereas in the group with stiffness> 70 the prevalence of axial osteoporosis was 8%. In women 65 years and over the corresponding values were 59% and 17%. Conclusions Of the four possible models for QUS, the use of QUS for the estimation of BMD, or in a “standalone” model, can not be recommended at the current time. The model of QUS as a “prescreening” modality may be acceptable assuming adequate education of clinicians and patients of its limitations, particularly the risk of false negatives. The model of QUS as one factor in a composite risk factor assessment of patients is promising but more data are required.