Discriminative ability of calcaneal quantitative ultrasound compared with dual-energy X-ray absorptiometry in men with hip or distal forearm fractures

Abstract

ObjectivesThe aim of this case–control study was to compare the discriminatory ability of bone mineral density (BMD) measurements and calcaneal quantitative ultrasound (QUS) parameters for fractures and to determine fracture thresholds for each variable in men with hip or distal forearm fractures.Patients and methodsA total of 20 men with hip and 18 men with distal forearm fractures and 38 age-matched controls were included in this study. Dual-energy X-ray absorptiometry (DXA) BMD (spine and hip) and calcaneal QUS measurements were made. Area under the curves (AUCs) were calculated to assess fracture discriminatory power of DXA and QUS variables.ResultsQuantitative Ultrasound Index (QUI) T-score and Speed of Sound (SOS) were found to be the best parameters for the identification of hip and distal forearm fractures, respectively, with AUCs greater than those of DXA BMD and other QUS parameters. While a QUI T-score of ≤−1.18 could identify and rule out hip fracture cases with approximately 80% sensitivity and specificity, a SOS value of ≤1529.75 reached to almost 90% for ruling in and out distal forearm fractures.ConclusionThe discriminatory performance of calcaneal QUS variables between fractured and non-fractured men was as good as those of the DXA BMD and even better. Since men appear to sustain fractures at closer QUS variable levels than those of the DXA BMD regardless of the fracture type, it may be speculated that calcaneal QUS may be more helpful in predicting the risk of fractures when BMD alone does not demonstrate impaired bones.Level of Evidence: Level III, Study of Diagnostic Test

Quantitative Ultrasound and Bone Health in Elderly People, a Systematic Review

“…According to the included studies, the average sample was constituted by 174 participants, with a mean age of 75 years, ranging from 50 to 89 years. Overall, the participants were people with osteoporotic fractures, osteoporotic fracture risk, and postmenopausal women [ 21 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

“…In every study, the patients were distributed equally and randomly into different groups, with no significant differences. Thus, three of the ten studies used a comparison control group of healthy elderly people [ 30 , 33 , 36 ].…”

“…It is important to consider the incidence of fractures in people over 50 years of age, especially in those over 85 years of age, among whom osteoporosis is not adequately evaluated, and its prevalence is greater than the number of diagnoses recorded [ 36 ]. These data confirm the results of our systematic review [ 33 ].…”

Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces

“…Systematic reviews and meta-analyses as well as the International Society for Clinical Densitometry (ISCD) validated QUS as being a good predictor for hip and other non-vertebral fractures and as reliable as DXA ( Marín et al, 2006 ; Moayyeri et al, 2012 ; Krieg et al, 2008 ). QUS is an independent predictor of fracture in men and women, even after adjusting for DXA ( McCloskey et al, 2015 ), and showed the same area under the curve as DXA in calculating the risk for fracture ( Esmaeilzadeh et al, 2016 ; Cesme, Esmaeilzadeh & Oral, 2016 ). Direct correlations between QUS and DXA showed a sensitivity of 70–85% and a specificity of 44–70% for detecting osteoporosis, and is therefore used as an estimated bone mineral density measurement (accuracy is not reported in these studies) ( Liu et al, 2019 ; Lee, Roh & Yoon, 2003 ).…”

Relationship between the Second to Fourth Finger Length Ratio and Calcaneus Quantitative Ultrasound

“…If such cancellous bone is frangible, then it will often cause osteoporosis. We used an ultrasound bone densitometer because it has no side effects and correlates well with the DXA-measured BMD 23 , 24 or bone mineral contents (BMC) 23 . The densitometer was operated by one researcher experienced in taking such measurements.…”