Ultrasound Measurements of Proximal Phalanges in Polish Early Postmenopausal Women

Abstract

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.

Quantitative Ultrasound at the Hand Phalanges in Adolescent Girls is Related to Their Overall Physical Fitness

“…CV% was established on the basis of 75 bone scans with repositioning of the device caliper (5 measurements in each subject). The detailed methodology was described by Pluskiewicz and Drozdzowska [20].…”

Quantitative ultrasound and bone health

“…5,27,32,33,[35][36][37] Multi-site quantitative ultrasound has demonstrated differing peak bone mass for different sites, with the weight bearing sites tending to peak earlier and have a lower rate of bone loss postmenopausally. 32,33 Studies evaluating premenopausal age related changes salud pública de méxico / vol.…”

“…51, suplemento 1 de 2009 Knapp KM at the phalanges using the DBM-sonic have also found age-related bone loss premenopausally. 4,5 Correlation with DXA The correlation of QUS measurements with BMD has generally yielded weak to moderate correlations, particularly when peripheral QUS measurement sites have been correlated with axial BMD. 7,33 Faulkner et al found correlations ranging from 0.26-0.63 for calcaneal QUS and DXA of the spine, hip, forearm and whole body.…”

“…However, there have also been devices introduced that measure the patella, tibia, phalanges, radius and metatarsal, using a range of techniques including transmission and semi-reflection or axial transmission mode ultrasound. [4][5][6][7][8][9][10] Dual X-ray absorptiometry (DXA) is currently the most widely used tool in the United Kingdom for the measurement of bone mineral density (BMD) and is widely regarded as the gold standard for the diagnosis of osteoporosis and fracture prediction. However, in many areas there are inadequate resources to meet the demand.…”

Quantitative ultrasound at the hand phalanges in adolescent boys in relation to their pubertal development and physical efficiency

“…The phalangeal quantitative ultrasound (QUS) measurement was introduced more than a decade ago and has been validated in various clinical studies [6][7][8][9]. This technique, by measuring the amplitude-dependent speed of sound, may provide useful information not only on bone mass but also on bone tissue architecture and elasticity.…”