Ultrasound velocity of the tibia in normal german women and hip fracture patients

Abstract

One of the latest developments in quantitative ultrasound (QUS) is the measurement of the speed of sound (SOS) of cortical bone of the midtibia. To determine the diagnostic validity of this method we measured 150 healthy women aged 22-94 years. Additionally, we report on first results of patients with hip fracture. Precision in vivo of the tibial QUS expressed as the percentage coefficient of variation (CV) was 0.39% for the first day and 0.45% after repositioning the second day (mean CV = 0.42%). No significant dependency of tibial SOS was found with weight, height, and body mass index in pre- and postmenopausal women. There was a significant decline of SOS with age in postmenopausal women (SOS = 4225 - 5.3 age, r = -0.46, P < 0. 001), whereas premenopausal women showed no decline (SOS = 3906 + 1. 3 age, r = 0.13, ns) Mean SOS values of premenopausal women were significantly higher than those of postmenopausal women (3960 +/- 78.7 m/second and 3898 +/- 120 m/second, respectively, P < 0.001). Postmenopausal women on estrogen substitution had significantly higher mean tibial SOS values than age-comparable postmenopausal women without estrogen substitution (3980 +/- 99 m/second and 3869 +/- 100 m/second, respectively, P < 0.001). Significant difference between age-matched healthy women, n = 11, and hip fracture patients, n = 13, expressed as z-score of -1.4 SD was found. In conclusion, tibial QUS declines with age and detects higher values in premenopausal women and postmenopausal women on estrogen substitution and lower values in hip fracture patients. Further prospective studies are needed to clarify its role in fracture risk assessment.

Quantitative Ultrasound Techniques for the Assessment of Osteoporosis: Expert Agreement on Current Status

“…Single point QUS systems for measurements at the finger phalanges using gel coupling 65–70 Assessment of ultrasound velocity measurements of the tibial cortex using gel coupling 45,71–73 …”

“…6. Precision and sensitivity: Many authors have investigated the short‐term precision of QUS measurements 37,38,45,46,48,62,73,81 . However, there is little information about the long‐term precision in vivo, and only a few longitudinal studies on changes of QUS parameters over time have been published 32,82,83 .…”

“…However, there is little information about the long‐term precision in vivo, and only a few longitudinal studies on changes of QUS parameters over time have been published 32,82,83 . While precision expressed as percentage looks excellent for some QUS parameters, 45,73,81 this may be misleading if responsiveness to skeletal changes is low 48,62,73 . Responsiveness is affected both by the measurement technique and the measurement site.…”

Speed of sound in bone at the tibia: is it related to lower limb bone mineral density in spinal-cord-injured individuals?

“…6,15,16 However, the four measurement sites available with the multisite device (radius, phalanx, metatarsal and tibia) may not have the same ability to predict fracture. Unlike the other three sites, tibia SOS was not able to distinguish women with vertebral fracture from women without vertebral fracture.…”

Osteosonographie der Phalangen bei Männern

“…60 bis 90% der Stabilitiit des Knochens k6nnen durch die Knochenmineralisation erkliirt werden [6,8,21]. Messungen dcr Ultraschallgeschwindigkeit, die ebenfalls mit der Knochendichte korreliert, haben in der Zahl der verwendeten Ger~ite ebenso wie in der Anzahl der Meflstellen aro K6rper in den letzten f'ª zugenommen [5,9,17,18]. Aber die verbleibenden Eigenschaften der Knochensffirke scheinen von anderen Charakte¡ des Knochens abzuh~ingen, wie zum Beispiel Elastizit~t, Geometrie und Struktur [7,21], welche durch Ultraschalltechniken analysiert werden k6nnen.…”