Calcaneal Ultrasound for Bone Mass

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Hi folks:

This study found that calcaneal (heel) ultrasound (no radiation

exposure and not expensive) measurements of bone 'density' were as

good as DXA at discriminating women with hip fractures from those

without them:

" In comparison to ................ DXA (femoral neck), both QUS-

devices showed an equal ability to significantly discriminate

postmenopausal women with proximal femoral fractures from healthy,

age- and BMI-matched controls. "

" [based on] the T-Score (femoral neck), all three devices ..........

showed an equal[ly] significant correlation (p < 0.001). "

The abstract:

Zentralbl Chir. 2005 Oct;130(5):469-75

[bone mineral density in postmenopausal women with proximal femoral

fractures--comparative study between quantitative ultrasonometry and

gold standard DXA][Article in German]

Schnabel M, Eser G, Ziller V, Mann D, Mann E, Hadji P.

Klinik für Unfall-, Wiederherstellungs- und Handchirurgie der

Philipps-Universität Marburg. schnabem@...

" INTRODUCTION: Osteoporosis associated proximal femoral fracture is a

major public health problem. Diagnostic assessment includes patients

history, laboratory testings and bone mineral density measurements.

Hereby, dual X-ray absorptiometry (DXA) is regarded as

the " Goldstandard " . Quantitative ultrasonometry (QUS) of bone is a

safe, simple, free of radiation, portable, cost-effective and

therefore powerful diagnostic tool. QUS should be taken in account

for primary assessment in patients with supposed osteoporosis in

clinical practice. AIM OF THE STUDY: We performed this cross

sectional pilot study to evaluate the ability of two different QUS-

devices (os calcis) in comparison to DXA (lumbar spine and femoral

neck) to discriminate postmenopausal women with proximal femoral

fractures from healthy, age- and BMI-matched controls. PATIENTS AND

METHODS: All together, 44 postmenopausal women were included. Of

these, 22 suffered a proximal femoral fracture and were compared with

22 healthy, age- and BMI-matched controls. Bone assessments were

performed by DXA (femoral neck and lumbar spine) and QUS of the heel

using Achilles and Insight. RESULTS: T- and Z-Score of DXA (femoral

neck) were significantly lower in women with hip fracture compared to

controls (p < 0.008 and p < 0.01). QUS-Insight also revealed

significantly lower values of T- and Z-Score in women with hip

fracture compared to controls (p < 0.01 and p < 0.005). QUS-Achilles

measurement results also comprised significant differences between

the groups (T-Score und Z-Score: p < 0.02). In accordance to the T-

Score (femoral neck), all three devices (DXA femoral neck, Achilles

and Insight) showed an equal significant correlation (p < 0.001). The

correlation in between both QUS-devices was higher (0.956; p <

0.0001) than in between DXA-results (femoral neck vs. lumbar spine,

0.577; p < 0.01). The Z-Score also showed a significant correlation.

DXA (lumbar spine) didn't show any significant differences in T- and

Z-Score. CONCLUSION: In comparison to the gold standard DXA (femoral

neck), both QUS-devices showed an equal ability to significantly

discriminate postmenopausal women with proximal femoral fractures

from healthy, age- and BMI-matched controls. If our results are

confirmed by more cross-sectional and longitudinal studies, QUS could

be a helpful and valuable technique in clinical practice. Finally,

all patients with osteoporosis-related fractures should be thoroughly

investigated during their hospitalisation and effective treatment

must be instituted. "

PMID: 16220445

Every few months a local drug store here is offering customers these

ultrasound tests for free. Seems to me it makes sense to take

advantage of this. Ultrasound is preferable to DXA, imo, in both

cost and radiation exposure. Although both methods, I think, measure

bone mass rather than porosity, while it is the latter that is what

is important, as previously discussed here at some length.

Rodney.