Quantitative ultrasound does not identify patients with an inflammatory disease at risk of vertebral deformities.
BACKGROUND
Previous studies from our group have shown that a high prevalence of vertebral deformities suggestive of fracture can be found in patients with an inflammatory disease, despite a near normal bone mineral density (BMD). As quantitative ultrasound (QUS) of the heel can be used for refined assessment of bone strength, we evaluated whether QUS can be used to identify subjects with an inflammatory disease with an increased chance of having a vertebral fracture.


METHODS
246 patients (mean age: 44 +/- 12.4 years) with an inflammatory disease (sarcoidosis or inflammatory bowel disease (IBD)) were studied. QUS of the heel and BMD of the hip (by dual X-ray absorptiometry (DXA)) were measured. Furthermore lateral single energy densitometry of the spine for assessment of vertebral deformities was done. Logistic regression analysis was performed to assess the strength of association between the prevalence of a vertebral deformity and BMD and QUS parameters, adjusted for gender and age.


RESULTS
Vertebral deformities (ratio of <0.80) were found in 72 vertebrae of 54 subjects (22%). In contrast to the QUS parameters BUA (broadband ultrasound attenuation) and SOS (speed of sound), T-score of QUS and T-scores of the femoral neck and trochanter (DXA) were lower in the group of patients with vertebral deformities. Logistic regression analysis showed that the vertebral deformity risk increases by about 60 to 90% per 1 SD reduction of BMD (T-score) determined with DXA but not with QUS.


CONCLUSIONS
Our findings imply that QUS measurements of the calcaneus in patients with an inflammatory condition, such as sarcoidosis and IBD, are likely of limited value to identify patients with a vertebral fracture.
Heijckmann
A Caroline
AC
Department Internal Medicine, Division of Endocrinology, University Hospital Maastricht, The Netherlands. caroline@heesen.eu
Dumitrescu
Bianca
B
Nieuwenhuijzen Kruseman
Arie C
AC
Geusens
Piet
P
Wolffenbuttel
Bruce H R
BH
De Vries
Jolanda
J
Drent
Marjolein
M
Huijberts
Maya S P
MS
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography