Potential roles for quantitative ultrasound in the management of osteoporosis.
OBJECTIVE
To assess the validity of four models for the role of quantitative ultrasound (QUS) in the management of osteoporosis.


METHODS
Cross-sectional survey and review of literature.


METHODS
Nuclear medicine departments of three teaching hospitals in Sydney.


METHODS
1000 women aged 22 to 88 years (mean, 59 years) referred for assessment of osteoporotic fracture risk.


METHODS
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 < or = 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.
Pocock
N A
NA
Department of Nuclear Medicine, St Vincent's Hospital, Sydney, NSW. n.pocock@UNSW.edu.au
Culton
N L
NL
Gilbert
G R
GR
Hoy
M L
ML
Babicheva
R
R
Chu
J M
JM
Lee
K S
KS
Freund
J
J
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015995:Prevalence; D011897:Random Allocation; D015203:Reproducibility of Results; D012307:Risk Factors; D014463:Ultrasonography; D014505:Urban Population