Quantitative ultrasound (QUS) parameters are temperature dependent. We examined the effect of temperature on QUS using Lunar Achilles+ and Hologic Sahara units. In vivo studies were performed in a cadaveric foot and in 5 volunteers. QUS scans were performed in the cadaveric foot, using both machines, at temperatures ranging from 15 to 40 degrees C. To assess the effect of change in water bath temperature in the Achilles+, independently of foot temperature, 5 volunteers were studied at water temperatures ranging from 10 to 42 degrees C. In the cadaveric foot there were strong negative correlations between temperature and speed of sound (SOS) but a moderately positive correlation between temperature and broadband ultrasound attenuation (BUA). Stiffness and the Quantitative Ultrasound Index (QUI) in the cadaveric foot showed strong negative correlations with temperature, reflecting their high dependence on SOS. In the 5 volunteers, in whom foot temperature was assumed to be constant, there was a small change in Stiffness in the Achilles+, with variation in water temperature. In conclusion, while there are opposite effects of temperature on SOS and BUA in vivo, there is still a significant effect of temperature variation on Stiffness and the QUI. This may have clinical significance in particular subjects. The precision of QUS may be affected by temperature variation of the environment or of the patient's limb. Instruments utilizing a water bath may be able partly to compensate for changes in environmental temperature, but standardization of water bath temperature is crucial to maximize precision.
With ageing of the Australian population, treatment of osteoporosis‐related hip fractures will impose an increasing burden on the healthcare system. Based on current age‐adjusted hip fracture incidence and population projections for New South Wales, we estimated a 90% increase in hip fractures by the year 2021. Contributing significantly to this increase will be the number of men reaching the high risk age group for osteoporotic hip fractures. A suggested solution — screening and appropriate therapy for individuals at high risk of osteoporosis — may have only a modest impact. Our calculations show that, even with optimistic screening and therapy compliance rates, hip fractures could still increase by over 50%. Other approaches need to be further explored. Email: n.pocock@unsw.edu.au
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