Quantitative heel ultrasound as a predictor for osteoporosis.
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.
Naganathan
V
V
Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW. vasin@med.usyd.edu.au
March
L
L
Hunter
D
D
Pocock
N A
NA
Markovey
J
J
Sambrook
P N
PN
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