title: Quantitative heel ultrasound as a predictor for osteoporosis.
abstract: 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.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Rheumatology department of a tertiary care hospital (Royal North Shore Hospital, Sydney, NSW), 1997-1998.
  
  
  METHODS
  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.
  
  
  METHODS
  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, infinity), 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.
  
  
  CONCLUSIONS
  These results suggest that, for most of those tested for osteoporosis by QUS in the community, uncertainty remains about expected BMD.
authors.affiliation: Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW. vasin@med.usyd.edu.au
authors.forename: V
authors.initials: V
authors.lastname: Naganathan
authors.forename: L
authors.initials: L
authors.lastname: March
authors.forename: D
authors.initials: D
authors.lastname: Hunter
authors.forename: N A
authors.initials: NA
authors.lastname: Pocock
authors.forename: J
authors.initials: J
authors.lastname: Markovey
authors.forename: P N
authors.initials: PN
authors.lastname: Sambrook
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D002111:Calcaneus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography