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Pulse-echo ultrasound measurement in osteoporosis screening: a pilot study in older patients

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Abstract

Background

A mere 25% of patients who need treatment for osteoporosis receive appropriate therapy, partly due to the time-consuming and stressful diagnostic workup for older patients with functional decline.

Aims

The purpose of the present study was to investigate the accuracy of pulse-echo ultrasound measurement of the lower leg for the detection of osteoporosis in older patients, and evaluate the effect of a proposed diagnostic algorithm.

Methods

Cortical thickness and the so-called density index (DI) were measured prospectively on the lower leg with a pulse-echo ultrasound (PEUS) device. The accuracy of the device was compared with dual-energy X-ray absorptiometry (DXA) of the hip. We calculated algorithms combining FRAX® scores and PEUS measures as a guide for specific treatment of osteoporosis.

Results

Three hundred and thirty-three patients aged on average 81 years (82.1% women, 275/333) were included in the study. The sensitivity of the ultrasound device versus DXA for the detection of osteoporosis was 94.4% (84/89), and the specificity was 59% (144/247). The gender-specific sensitivity was 96.2% (75/78) for women and 81.8% (9/11) for men.

Discussion

Clinical decisions for the specific treatment of osteoporosis could be based on the proposed algorithm, without additional DXA measurements, in 90.9% (303/333) of the patients.

Conclusion

Older patients with a similar risk profile as in our study population may benefit from PEUS, as it is a non-invasive, cost-effective, and efficient diagnostic tool with high accuracy in screening patients for osteoporosis and the risk of fractures.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, [PD].

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Acknowledgements

We thank Janne Karjalainen for his helpful notes during the statistical processing of our data. Sponsor`s role: The study was performed using a Bindex® device, Bone Index Finland Oy, Kuopio, Finland, which was provided by Drott Medizintechnik, Wiener Neudorf, Austria. We thank Sujata Wagner from the Medical Translation Agency for their English language editing.

Funding

The study was performed using a Bindex® device, Bone Index Finland Oy, Kuopio, Finland, that was provided from Drott Medicine Technique, Wiener Neudorf, Austria.

Author information

Authors and Affiliations

  1. Department of Acute Geriatrics, Salzkammergut Clinic Gmunden, Miller Von Aichholzstraße 49, 4810, Gmunden, Austria

    Peter Dovjak & Anna Rainer

  2. Department of Geriatric Medicine, Christian Doppler Hospital, Paracelsus Medical University, Salzburg, Austria

    Bernhard Iglseder

  3. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria

    Gregor Dovjak & Michael Weber

  4. Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria

    Peter Pietschmann

Authors
  1. Peter Dovjak
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  2. Bernhard Iglseder
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  3. Anna Rainer
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  4. Gregor Dovjak
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  5. Michael Weber
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  6. Peter Pietschmann
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Contributions

Conceptualization (PP, BI), study proposal (PP, PD, MW, GD), data acquisition (PD, AR), data analysis. (PD, MW, GD,) and interpretation (PP, PD, BI, GD), initial manuscript (PD), and critical revision (all). All authors contributed to the drafting and revision of the manuscript.

Corresponding author

Correspondence to Peter Dovjak.

Ethics declarations

Conflict of interest

PD, BI, AR, GD, MW, and PP declared no financial or personal conflict of interest.

Statement of human and animal rights

No animals were studied in our research.

Informed consent

Informed consent was obtained in writing from all patients prior to enrollment. The study was approved by the ethics review board of Upper Austria in accordance with the Declaration of Helsinki 1964, revised in 2013 at the general assembly in Fortaleza, Brazil (ethics committee approval number 1103/2018).

Impact statement

We certify that this work is novel. It could lead to a more convenient screening of osteoporosis in older patients and might reduce fragility fractures subsequently.

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Dovjak, P., Iglseder, B., Rainer, A. et al. Pulse-echo ultrasound measurement in osteoporosis screening: a pilot study in older patients. Aging Clin Exp Res 35, 1221–1230 (2023). https://doi.org/10.1007/s40520-023-02404-z

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  • DOI: https://doi.org/10.1007/s40520-023-02404-z

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