Evaluation of osteoporosis using calcaneal QUS and FRAX score as a screening tool in a semi urban tertiary care hospital of South India

Abstract

The risk factors identified worldwide for development of osteoporosis are female sex, old age, small thin build or ABSTRACT Background: Osteoporosis is a silent, often found late, underdiagnosed disease characterized by low bone mass leading to increased susceptibility to fractures. With an increasingly aging population, the proportion of patients with osteopenia and osteoporosis are increasing in both developed and developing countries. The available data on osteoporosis is scanty from India. Methods: The objective was to measure the bone mineral density (BMD) of the patients using calcaneal Quantitative Ultrasound (QUS) and determine the risk factors along with the FRAX score. This was a hospital based cross sectional study conducted in a tertiary care hospital done on 183 out patients. BMD was measured using calcaneal QUS & T scores were calculated along with the FRAX score. Results: The prevalence of osteoporosis was 29.5% and osteopenia was 42.1%.The age wise analysis of BMD revealed males have the tendency to lose their bone mass after the age of 40 years while in females, the trend begins a decade earlier. The mean BMD of post-menopausal females was significantly lower compared to pre-menopausal females (-2.72 ± 1.33 vs-1.63 ± 1.06, P < 0.0001).Linear regression analysis revealed a complex linear relationship between the FRAX score and the BMD and it was statistically significant. Conclusions: Calcaneal QUS can be used as a screening tool to screen for and detect osteoporosis. It is economical, portable and easily available in many parts of the country. DEXA scan, the gold standard test to diagnose osteoporosis can be used to confirm the diagnosis in selected cases.

Prevalence and Patterns of Risk of Osteoporosis in Bangladeshi Adult Population: An Analysis of Calcaneus Quantitative Ultrasound Measurements

“…In low and middle-income countries, the primary barrier to osteoporosis or RO assessment is the lack of cost-effective screening tools [9]. Though Dual-energy X-ray absorptiometry (DXA) is recognized as the gold standard screening tool for osteoporosis [10], it is less accessible and less cost-feasible for low-income countries, for example, Bangladesh [11].…”

Performance of Sri Lankan FRAX algorithm without bone mineral density and with Quantitative Ultrasound data input

“…In support of this, studies have shown poor agreement between radial US and DXA technics and thus suggested radial QUS is not a good alternative to DXA [27,31,36]. On the other hand, QUS of calcaneus showed good correlations with DXA BMD [28,37]. This study has some limitations.…”

Screening for absolute fracture risk using FRAX tool in men and women within 40-90 years in urban population of Puducherry, India

“…10 The present guidelines in India recommend that postmenopausal women with a prior fragility fracture may be considered for interventions without the necessity for a BMD test (other than to monitor treatment). 11 Prior to the introduction of FRAX tool, there was no universally accepted screening tool for osteoporosis in India. On the basis of a series of meta-analyses undertaken to identify clinical risk factors for osteoporosis, the Fracture Risk Assessment Tool (FRAX) was developed.…”