Re: Bone density and ultrasoud.

From: art fougner, md (evsono@pipeline.com)
Wed Feb 7 09:29:04 2001


very timely question since offices are being inundated with fliers. here's a reference to start things off -

Osteoporos Int 2000;11(4):354-60

Assessment of a new quantitative ultrasound calcaneus measurement: precision and discrimination of hip fractures in elderly women compared with dual X-ray absorptiometry.

He YQ, Fan B, Hans D, Li J, Wu CY, Njeh CF, Zhao S, Lu Y, Tsuda-Futami E, Fuerst T, Genant HK

Department of Radiology, University of California, San Francisco 94143-1349, USA.

The incidence of osteoporotic hip fracture increases in postmenopausal women with low hip bone mineral density (BMD). Dual X-ray absorptiometry (DXA) is the most commonly used technique for the assessment of bone status and provides good measurement precision. However, DXA affords little information about bone architecture. Quantitative ultrasound (QUS) systems have been developed to evaluate bone status for assessment of fracture risk. Our study was designed to assess a new QUS system from Hologic, the Sahara; to compare it with a previous model, the Walker-Sonix UBA 575+; and to investigate whether it is able to discriminate between women with and without fracture. Using both ultrasound devices, the measurements were performed at the heels of 33 postmenopausal women who had recently sustained hip fracture. A control group of 35 age-matched postmenopausal women was recruited for comparison. The total, neck and trochanter femoral BMD values were assessed using DXA for both groups. QUS and DXA measurements were significantly lower in fractured patients (p < 0.005) than in the control group. The short-term, mid-term and standardized short-term precisions were used to evaluate the reproducibility of the two QUS systems. The Sahara showed a better standardized coefficient of variation for broadband ultrasound attenuation (BUA) than did the UBA 575+ (p < 0.001). The correlation of BUA and speed of sound (SOS) between the two QUS devices was highly significant, with an r value of 0.92 for BUA and 0.91 for SOS. However, the correlation between DXA and ultrasound parameters ranged from 0.28 to 0.44. We found that ultrasound measurements at the heel were significant discriminators of hip fractures with odds ratios (OR) ranging from 2.7 to 3.2. Even after adjusting the logistic regressions for total, neck or trochanter femoral BMD, QUS variables were still significant independent discriminators of hip fracture. The areas under the ROC curves of each ultrasound parameter ranged from 0.75 to 0.78, and compared very well with femoral neck BMD (p > 0.05). In conclusion, our study indicated that the calcaneal QUS variables, as measured by the Sahara system can discriminate hip fracture patients equally as well as hip DXA.

PMID: 10928226

hope this helps

art

At Tue, 6 Feb 2001, Efrain Ramirez wrote: >
>My understanding is that U/S +and+ BMD provide complementary information
>which can be use as to improve chances of vertebral fracture risks - but
>I still use Bone Densitometry as my primary diagnostic tool-not U/S in
>fact -I've never ordered U/S..
>
> At Tue, 6 Feb 2001, Douglas Krell wrote:
>>
>> Can anyone provide me with information regarding bone "density" evaluation using
>> ultrasound rather than DEXA scanning. Does anyone have opinions about this modality for
>> evaluating bone quality.
>>
>>--
>> Douglas Krell MD
>>
>--
>"Life is neither the notes nor the silence between the notes, but the music that
> arises out of sound and silence felt as a living whole. Stop choosing...between
> chaos and order, and live at the boundary between them, where rest and action
> move together..." David Whyte
>

--
art fougner, md

A series of 1000 cases begins with but a single anecdote.





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