Quantitative Ultrasound at the Phalanges in Healthy Italian Men

Abstract

In the last decade there has been a growing interest in quantitative ultrasound (QUS) techniques as a new method in the assessment of bone status in metabolic bone diseases. Many studies have shown that QUS parameters can predict vertebral and femoral fracture risk in patients with osteoporosis. However, most of the studies were performed in women, whereas few data are available for men. The aim of this study was to build up a normative database on a healthy Italian male population for QUS parameters at the phalanges. Amplitude-dependent speed of sound (AD-SoS) and three parameters (first wave amplitude, FWA; signal dynamic, SDy; time frame, TF) characterizing the graphic trace of the ultrasound signal were measured at the phalanges in 286 healthy subjects (age range 20-87 years). First, the QUS device was adapted to compensate for the difference in finger thickness between men and women. Preliminary data on 150 healthy subjects showed a significant difference between the traditional and adapted device, and the latter was independent of finger thickness variations. AD-SoS showed a significant (p<0.001) decrease with aging, expressed by a second-order polynomial equation. The peak value (2122 m/s) was observed in the fourth decade; thereafter it decreased to 1980 m/s at the ninth decade. Likewise, FWA and SDy were significantly (p<0.001) reduced after the fourth decade, whereas TF remained stable over time until the last decade. In conclusion, in men AD-SoS showed a negative trend with aging. The pattern with aging of parameters characterizing the graphic trace was different from the pattern for AD-SoS, suggesting the possibility of obtaining further information on phalanx bone physical properties which could be useful in the differential diagnosis of metabolic bone diseases and in the assessment of fracture risk.

Graphic Trace Analysis of Ultrasound at the Phalanges May Differentiate Between Subjects with Primary Hyperparathyroidism and with Osteoporosis: A Pilot Study

“…Likewise, in the present study FWA and UBPI were particularly affected in OP patients. On the contrary BTT, which is mainly influenced by cortical width, as reported by Machado et al [32] and by ourselves [33], was decreased more in PHPT patients than in OP patients or healthy subjects.…”

“…Recent studies on human or pig phalanx have pointed out that the quantitative analysis of QUS signal morphology could give further information on structural changes of bone [21,22,31]. To date, this innovative analysis has been performed only in three studies, carried out on postmenopausal women [23], on men [32] and on patients with PHPT who were being treated with alendronate [33]. All these studies seem to suggest a close relationship between cortical width and BTT [21], whereas no correlation was found between cortical width and FWA [22].…”

Quantitative Ultrasound in Diagnosis of Metabolic Bone Diseases

“…Majority of them were conducted in normal, healthy males [27][28][29][30][31][32], and some studies were aimed to discriminate fractured from non-fractured males [33,34]. OR ranged from 1.05 to 3.4 [33,34].…”

Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

“…Interestingly, an Italian study proved that QUS at the phalanx is more sensitive in discriminating subjects with and without vertebral fractures immediately postmenopause, prior to the age of 70 years, while the effectiveness of the method in predicting hip fractures in the elderly population was inadequate; on the contrary, QUS at the calcaneus resulted more sensitive in the subsequent period, at the age of 70 years and older [52,62,63] . Recently, the study of bone tissue by US has been extended to the male population both in Italy and in Germany, obtaining good results also in this case [64][65][66][67] . In addition, NORA, the largest study of post-menopausal osteoporosis conducted in the United States (performed on 200000 women), showed a high degree of predictability for phalanx fracture risk [odds ratio (OR) = 4.86], forearm (OR = 2.86) and heel (OR = 1) [68] .…”