title: Utility of quantitative ultrasound of the calcaneus in diagnosing osteoporosis in spinal cord injury patients.
abstract: OBJECTIVE
  : The aim of this study was to assess the utility of quantitative ultrasound of the calcaneus in diagnosing osteoporosis in spinal cord injury patients in a Brazilian Teaching Hospital.
  
  
  METHODS
  : This is a diagnostic test criterion standard comparison study. Between January 2008 and October 2009, the bone density of 15 spinal cord injury patients was assessed for analysis before beginning rehabilitation using muscle stimulation. The bone density was assessed using bone densitometry examination (DEXA) and ultrasound examination of the calcaneus (QUS). The measurements acquired using QUS and DEXA were compared between patients with spinal cord injury and a control group of ten healthy individuals.
  
  
  RESULTS
  : The T-score values for femoral neck using DEXA (P < 0.0022) and those using QUS of the calcaneus (P < 0.0005) differed significantly between the groups, and the means in the normal subjects were higher than those in spinal cord injury patients who would receive electrical stimulation. In spinal cord injury patients, the significant differences were found between the QUS T-score for calcaneus and the DEXA scores for the lumbar spine and femoral neck.
  
  
  CONCLUSIONS
  : Because of the low level of mechanical stress on the calcaneus, the results of the QUS could not be correlated with the DEXA results for diagnosing osteoporosis. Therefore, QUS seems to be not a good choice for diagnosis and follow-up.
authors.affiliation: Orthopaedics Department, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Cíntia Kelly
authors.initials: CK
authors.lastname: Bittar
authors.forename: Alberto
authors.initials: A
authors.lastname: Cliquet
authors.forename: Michelle
authors.initials: M
authors.lastname: Dos Santos Flöter
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000328:Adult; D000367:Age Factors; D015519:Bone Density / Q000502:physiology; D002111:Calcaneus / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010024:Osteoporosis / Q000175:diagnosis* / Q000209:etiology; D010264:Paraplegia / Q000150:complications / Q000503:physiopathology; D011782:Quadriplegia / Q000150:complications / Q000503:physiopathology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D018608:Ultrasonography, Doppler / Q000706:statistics & numerical data; D055815:Young Adult