Clinical Performance of a Highly Portable, Scanning Calcaneal Ultrasonometer |
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Authors: | S L Greenspan S Cheng P D Miller E S Orwoll |
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Institution: | Divisions of Endocrinology and Metabolism, and Geriatric Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA, US Department of Health Sciences, University of Jyv?skyl?, Jyv?skyl?, Finland, FI Department of Medicine, University of Colorado Health Sciences Center, US Department of Medicine, Oregon Health Sciences University, Portland, OR, USA, US
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Abstract: | The aim of this study was to establish a normative database, assess precision, and evaluate the ability to identify women
with low bone mass and to discriminate women with fracture from those without for a highly portable, scanning calcaneal ultrasonometer:
the QUS-2. Fourteen hundred and one Caucasian women were recruited for the study. Among them were 794 healthy women 25–84
years of age evenly distributed per 10-year period to establish a normative database. Of these, 171 aged 25–34 years were
defined as the young normal group for the purpose of T-score determination. Precision was assessed within 1 day (short-term) and over a 16-week period (long-term) in 79 women aged
25–84 years. Five hundred twenty-eight women ranging from 50 to 84 years of age with or without prevalent fractures of the
spine, hip or forearm were measured to compare the QUS-2 with bone mineral density (BMD) of the hip and spine. Mean calcaneal
broadband ultrasound attenuation (BUA) was constant in healthy women from 25 to 54 years of age and decreased with increasing
age thereafter. Short-term precision, with and without repositioning of the heel, and long-term precision yielded comparable
results (BUA SDs of 2.1–2.4 dB/MHz, coefficients of variations (CVs) of 2.5–2.9%). Calcaneal BUA was significantly correlated
with BMD of the total hip (TH), femoral neck (FN) and lumbar spine (LS) in 698 women (r= 0.6–0.7, all p<0.0001). A similar relationship was observed for LS BMD compared with either TH or FN BMD (r= 0.7, p<0.0001). Prevalence of osteoporosis in our population (WHO criteria) was 20%, 17%, 21%, and 24% for BUA, BMD of the TH, FN
and LS, respectively. Age-adjusted values for a 1 SD reduction in calcaneal BUA and TH and FN BMD predicted prevalent fractures
of the spine, forearm, and hip with significant (p<0.05) odds ratios of 2.3, 2.0 and 2.1, respectively. Areas under the receiver operating characteristic curves for age-adjusted
bone mass values predicting prevalent fracture were 0.62 for BUA, 0.59 for TH BMD, 0.60 for FN BMD, and 0.57 for LS BMD; all
statistically equivalent. We conclude that the QUS-2 calcaneal ultrasonometer exhibits reproducible clinical performance that
is similar to BMD of the spine and hip in identifying women with low bone mass and discriminating women with fracture from
those without.
Received: 19 July 2000 / Accepted: 6 December 2000 |
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Keywords: | :Bone mineral density – Calcaneus – Fracture – Osteoporosis – Ultrasound |
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