Decreased broadband ultrasound attenuation of the calcaneus in women with fragility fracture: 85 Colles' and hip fracture cases versus 77 normal women

Ec, Dretakis; Gm, Kontakis; Ca, Steriopoulos; Ce, Dretakis

doi:10.3109/17453679408995458

Cited by 21 publications

(8 citation statements)

References 16 publications

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“…Several cross-sectional and prospective studies have demonstrated that subjects with fractures have lower speed of sound values and BUA than subjects without fractures [5][6][7][8]22]. The age-adjusted odds ratio for lowtrauma fracture for each 1 SD decrease in either speed of sound or BUA in peripheral measurement sites ranges from 1.24 at the patella [23] to 3.7 at the calcaneus [24].…”

Section: Discussionmentioning

confidence: 99%

“…One of the most important questions concerning the use in a clinical setting of quantitative ultrasound (QUS) is whether this technology is capable of detecting subjects at risk of fracture. Cross-sectional studies have demonstrated that subjects with osteoporotic fractures have lower values of ultrasound velocity and of broadband ultrasound attenuation (BUA) than subjects without fractures [7,8]. In the majority of studies the calcaneus was used as the measurement site [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound Measurements of Proximal Phalanges in Polish Early Postmenopausal Women

Pluskiewicz

Drozdzowska²

1998

Osteoporosis International

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The aim of this cross-sectional study was to evaluate skeletal status in Polish early postmenopausal women using ultrasound measurement at the proximal phalanges of the hand. We assessed the ability of the method to discriminate between healthy and osteoporotic individuals, the influence of age and menopause on ultrasound values, the impact of hormone replacement therapy and the relationships between ultrasound measurement and type of fracture. Five hundred and three early postmenopausal women were divided into three groups: (1) healthy (n = 398, mean age 53.4 years), (2) fractured (n = 43, mean age 53.9 years), (3) treated with estrogens (n = 62, mean age 53.5 years). Groups were matched for age and years since menopause (YSM). Group 2 was subdivided into those with and without wrist fracture. No drugs except estrogens were used by the subjects studied and no diseases known to affect bone metabolism were observed. Bone status was assessed by a DBM Sonic 1200 (Igea, Italy), a device that measures amplitude-dependent speed of sound (AD-SoS) at the proximal phalanges II-V of the hand. AD-SoS had the highest value in estrogen-treated women (1996.5 +/- 66.5 m/s), the lowest in fractured persons (1883.6 +/- 77.1 m/s) and a medium value in healthy women (1949.2 +/- 78.0 m/s). All values were significantly different from each other (p < 0.0001). AD-SoS values for the subgroups of group 2 were 1873.0 +/- 80.6 m/s for those with wrist fracture and 1914.0 +/- 73.0 m/s for those without; they were not statistically different. The hypothesis that AD-SoS at the proximal phalanges might be more sensitive to wrist fracture was not confirmed by Fisher's exact test for frequencies. Linear regression showed age-related changes, with r values -0.4 (p < 0.00001), -0.47 (p < 0.005), -0.37 (p < 0.005), and YSM-related changes, with r values of -0.44 (p < 0.00001), -0.32 (p < 0.005), and -0.18 (NS) in groups 1, 2 and 3, respectively. It is concluded that: (1) ultrasound measurements of the proximal phalanges were able to discriminate between healthy and osteoporotic individuals; (2) the method is useful in detecting age and postmenopause-related changes within the skeleton; and (3) hormone replacement therapy significantly reduced the impact of the menopause on bone loss as detected by ultrasound.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound Measurements of Proximal Phalanges in Polish Early Postmenopausal Women

Pluskiewicz

Drozdzowska²

1998

Osteoporosis International

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“…Although the majority of investigations have been made with QUS at the calcaneus, finding associations with vertebral [43, 56,57,[61][62][63][64], hip and forearm fractures [65,66], recently reports have begun to appear showing similar capabilities for ultrasound measurements at the patella, tibia and phalanges [46,62,[67][68][69][70][71][72]. Indeed, tibial SOS has been associated with incident non-spine fractures [62].…”

Section: Conclusion Drawn From Current In Vivo Studies?mentioning

confidence: 99%

Quantitative ultrasound bone measurement

1997

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“…Many clinical studies have shown a reduction in QUS values in women with primary osteoporosis, even when osteoporosis was defined by different methods: densitometric, radiographic (detection of vertebral fractures), history of recent hip fracture, and self-reported history of previous osteoporotic fractures (5,12,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). In preliminary studies, QUS has also been shown to be useful in patients with secondary osteoporosis, including patients with inflammatory bowel disease (30), chronic renal failure (31), reflex sympathetic dystrophy (32), bronchial asthma receiving chronic steroid therapy (33), spaceflight-induced bone loss (34), young ballet dancers (35), glucocorticoid-induced osteoporosis (36), and rheumatoid arthritis (37), and in normal pregnancy (38).…”

Section: Tanveer E Towheedmentioning

confidence: 99%

Quantitative ultrasound: Is it a useful test in osteoporosis?

Towheed

1999

Arthritis & Rheumatism

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Osteoporosis is a systemic skeletal disease characterized by low bone mass, which results in an increased risk of fractures. Using the World Health Organization definition of osteoporosis (bone mineral density Ͼ 2.5 standard deviations below the young normal mean), an estimated 9 million postmenopausal white women in the United States have osteoporosis, and almost 17 million have osteopenia (bone mineral density more than 1 standard deviation below the young normal mean, but not less than 2.5 standard deviations below). Therefore, about 26 million white postmenopausal women are at increased risk for fracture (1,2). About 5 million women are estimated to have established osteoporosis (osteoporosis with a history of fragility fractures).Significant improvements in the radiologic diagnosis of osteoporosis have been made since the arrival of dual-energy x-ray absortiometry (DXA) and quantitative computed tomography (QCT). These methods offer the most precision and accuracy for the in vivo measurement of bone mineral mass (3). They measure bone mineral mass/density (BMD), which is a measure of bone quantity and a strong predictor of fractures. Bone quality, as measured by trabecular connectivity, spacing, elasticity, stiffness, microfractures, and in vitro resistance to fracture loads, has also been shown to predict osteoporotic fractures (4 -6). Therefore, the ideal diagnostic instrument for assessing osteoporosis and predicting the risk of subsequent fractures should measure both bone quantity and bone quality. Quantitative ultrasound (QUS) has recently been introduced for this purpose, and, thus far, has shown promising results when directly compared with DXA and QCT.The use of ultrasound to measure the intrinsic properties of bone is based on the following observation: the acoustic properties of any composite material such as bone depend not only on the amount of the various constituent materials, but also on their spatial arrangement. In 1984, Langton et al (7) first demonstrated the utility of the broadband ultrasound attenuation (BUA) measurement of the calcaneus in patients with osteoporosis.The ultrasonic method involves the passing of sound waves through bone, which allows the measurement of the attenuation (BUA) and velocity of sound (VOS) through bone (8,9). The VOS is related to the elasticity and stiffness of bone, whereas the BUA is believed to be related more to the trabecular microarchitecture (4,6,9 -11). QUS measurements have been mostly taken at the calcaneus, and less so at the hand, patella, and tibia. For the purposes of this review, QUS refers to any quantitative parameter of bone measurement at any site. BUA refers to the attenuation of ultrasound energy in the calcaneus, and VOS refers to the velocity of sound at either the calcaneus, tibia, hand, or the patella. Values of the BUA and VOS are proportional to the amount of bone present in the measured site. A greater amount of bone will result in a greater degree of attenuation of the sound energy, reflected by a higher BUA value. Normal bone ...

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Decreased broadband ultrasound attenuation of the calcaneus in women with fragility fracture: 85 Colles' and hip fracture cases versus 77 normal women

Cited by 21 publications

References 16 publications

Ultrasound Measurements of Proximal Phalanges in Polish Early Postmenopausal Women

Ultrasound Measurements of Proximal Phalanges in Polish Early Postmenopausal Women

Quantitative ultrasound bone measurement

Quantitative ultrasound: Is it a useful test in osteoporosis?

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