title: A comparison of calcaneal dual-energy X-ray absorptiometry and calcaneal ultrasound for predicting the diagnosis of osteoporosis from hip and spine bone densitometry.
abstract: Peripheral densitometry is increasingly being used in the management of osteoporosis, but the optimal diagnostic thresholds have not been defined. The aim of this study was to determine the optimal T-score for peripheral dual-energy X-ray absorptiometry (pDXA) of the heel using a GE Lunar PIXI and quantitative ultrasound (QUS) of the heel using a GE Lunar Achilles Plus when compared with dual-energy X-ray absorptiometry (DXA) of central sites (spine, femoral neck, or total hip). Ninety-nine women (mean age 69 +/- 8, range 33-86 yr) referred from the metabolic bone clinic were studied. The optimal T-score for pDXA from ROC analysis was -1.7 and for QUS was -2.5. The pDXA T-score that defined the same prevalence of osteoporosis at any central site was also -1.7 and for QUS was -2.4. These results are similar to the manufacturer's recommendations. There is no significant difference in performance between the PIXI and QUS.
authors.affiliation: Nottingham City Hospital NHS Trust, University Hospital NHS Trust, Nottingham, UK. dpearson@ncht.trent.nhs.uk
authors.forename: Derek
authors.initials: D
authors.lastname: Pearson
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
authors.forename: Opinder
authors.initials: O
authors.lastname: Sahota
authors.forename: Susan
authors.initials: S
authors.lastname: Earnshaw
authors.forename: David
authors.initials: D
authors.lastname: Hosking
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002111:Calcaneus / Q000000981:diagnostic imaging*; D005260:Female; D006615:Hip; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013131:Spine; D014463:Ultrasonography