title: Does quantitative tibial ultrasound predict low bone mineral density defined by dual energy X-ray absorptiometry?
abstract: OBJECTIVE
  Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD.
  
  
  METHODS
  One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS.
  
  
  RESULTS
  The SOS values were observed to be significantly higher in the normal BMD (t score > -1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < -1). SOS was negatively correlated with age (r= -0.66) and month since menopause (r= -0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites.
  
  
  CONCLUSIONS
  Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Trakya University Hospital, Edirne, Turkey. hakantuna@trakya.edu.tr
authors.forename: Hakan
authors.initials: H
authors.lastname: Tuna
authors.forename: Murat
authors.initials: M
authors.lastname: Birtane
authors.forename: Galip
authors.initials: G
authors.lastname: Ekuklu
authors.forename: Fikret
authors.initials: F
authors.lastname: Cermik
authors.forename: Filiz
authors.initials: F
authors.lastname: Tuna
authors.forename: Siranus
authors.initials: S
authors.lastname: Kokino
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D015519:Bone Density; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000378:metabolism; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013131:Spine / Q000000981:diagnostic imaging / Q000378:metabolism; D013977:Tibia / Q000000981:diagnostic imaging* / Q000378:metabolism; D014463:Ultrasonography