Osteoporosis International

, Volume 16, Issue 9, pp 1071–1078 | Cite as

Comparison of quantitative ultrasound of the phalanges with conventional bone densitometry in healthy postmenopausal women

  • Peter Alexandersen
  • Francesca de Terlizzi
  • Laszló B. Tankó
  • Yu Z. Bagger
  • Claus Christiansen
Original Article

Abstract

The objective of this study was to evaluate the utility of the quantitative ultrasound (QUS) technique for the identification of subjects with spine fracture or low bone mineral density (BMD) previously determined by dual energy X-ray absorptiometry (DEXA). QUS of the phalanges in 1,350 postmenopausal women (60–83 years old) was compared with DEXA measurements of four skeletal sites (lumbar spine, total hip, femoral neck, and distal radius) of the same subjects. The contribution of body mass index (BMI) was also assessed. Amplitude dependent speed of sound (AD-SoS), ultrasound bone profile index (UBPI), and BMD of all anatomical regions, except for the spine, decreased significantly with increasing age quartiles. QUS parameters correlated weakly but significantly with BMD ( r =0.21–0.31, p <0.01). After adjustment for BMI, the association between QUS parameters and BMD remained unchanged. UBPI was found to be independent of BMI. All techniques and all sites were able to significantly discriminate fractured from non-fractured subjects by receiver operating characteristic (ROC) analysis (area under the curve [AUC]≥0.60, p <0.0001). AD-SoS and UBPI showed similar fracture discrimination ability of spine, distal radius and total body BMD in terms of odds ratios, but BMD of the total hip and femoral neck showed the best performance in discriminating fractured from non-fractured subjects. In conclusion, QUS assessment of the phalanges correlates moderately with BMD of all skeletal sites and is able to effectively discriminate fractured from non-fractured subjects.

Keywords

Bone mass DEXA Fracture discrimination Postmenopausal women QUS 

Notes

Acknowledgments

We thank Dr. Ruggero Cadossi for his critical reading of the manuscript

References

  1. 1.
    Hans D, Dargent-Molina P, Schott AM, Sebert JL, Cormier C, Kotzki PO, Delmas PD, Pouilles JM, Breart G, Meunier PJ (1996). Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study. Lancet 348:511–514CrossRefPubMedGoogle Scholar
  2. 2.
    Schott AM, Weill-Engerer S, Hans D, Duboeuf F, Delmas PD, Meunier PJ. (1995). Ultrasound discriminates patients with hip fracture equally well as dual energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 10:243–249PubMedGoogle Scholar
  3. 3.
    Montagnani A, Gonnelli S, Cepollaro C, Mangeri M, Monaco R, Gennari L, Gennari C (2001). Usefulness of bone quantitative ultrasound in management of osteoporosis in men. J Clin Densitom 4:2321–2237Google Scholar
  4. 4.
    Glüer CC (1997). Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group. J Bone Miner Res 12:1280–1288PubMedGoogle Scholar
  5. 5.
    Joly J, Westhovens R, Borghs H, Peeters H, Tirry J, Nijs J, Dequeker J (1999) Reference curve and diagnostic sensitivity for a new ultrasound device for the phalanges, the BBM Sonic 1200, in Belgian women. Osteoporos Int 9:284–289PubMedGoogle Scholar
  6. 6.
    Wüster C, Albanese C, De Aloysio D, Duboeuf F, Gambacciani M, Gonnelli S, Gluer CC, Hans D, Joly J, Reginster JY, De Terlizzi F, Cadossi R (2000) Phalangeal osteosonogrammetry study: age-related changes, diagnostic sensitivity and discrimination power. J Bone Miner Res 15:1603–1614PubMedGoogle Scholar
  7. 7.
    Reginster JY, Dethor M, Pirenne H, Dewe W, Albert A (1999) Reproducibility and diagnostic sensitivity of ultrasonometry of the phalanges to assess osteoporosis. Int J Gynaecol Obstet 63:21–28Google Scholar
  8. 8.
    Mele R, Masci G, Ventura V, de Aloysio D, Bicocchi M, Cadossi R (1997) Three-year longitudinal study with quantitative ultrasound at the hand phalanx in a female population. Osteoporos Int 7:550–557PubMedGoogle Scholar
  9. 9.
    Rico H, Aguado F, Arribas I, Hernandez ER, Villa LF, Seco C, Gervas JJ (2001) Behavior of phalangeal bone ultrasound in normal women with relation to gonadal status and body mass index. Osteoporos Int 12:450–455Google Scholar
  10. 10.
    Alenfeld FE, Wüster C, Funck C, Pereira-Lima JF, Fritz T, Meeder PJ, Ziegler R (1998) Ultrasound measurements at the proximal phalanges in healthy women and patients with hip fractures. Osteoporos Int 8:393–398CrossRefPubMedGoogle Scholar
  11. 11.
    Gregg EW, Kriska AM, Salamone LM, Wolf RL, Roberts MM, Ferrell RE, Anderson SJ, Kuller LH, Cauley JA (1999) Correlates of quantitative ultrasound in the Women’s Healthy Lifestyle Project. Osteoporos Int 10:416–424CrossRefPubMedGoogle Scholar
  12. 12.
    Warming L, Hassager C, Christiansen C (2002) Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporos Int 13:105–112CrossRefPubMedGoogle Scholar
  13. 13.
    Mundy GR (1998) Bone remodeling and mechanisms of bone loss in osteoporosis. In: PJ Meunier (ed) Osteoporosis: diagnosis and management. Martin Dunitz, London, pp 17–35Google Scholar
  14. 14.
    Benitez CL, Schneider DL, Barrett-Connor E, Sartoris DJ (2000) Hand ultrasound for osteoporosis screening in postmenopausal women. Osteoporos Int 11:203–210CrossRefPubMedGoogle Scholar
  15. 15.
    Miller PD, Siris ES, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Chen YT, Berger ML, Santora AC, Sherwood LM (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17:2222–2230PubMedGoogle Scholar
  16. 16.
    Bauer DC, Bauer DC, Palermo L, Black D, Cauley JA (2002) Quantitative ultrasound and mortality: a prospective study. Osteoporos Int 13:606–612Google Scholar
  17. 17.
    Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S (2003) Lifestyle factors are associated with osteoporosis in lean women but not in normal and overweight women: a population-based cohort study of 1,222 women. Osteoporos Int 14:34–43CrossRefPubMedGoogle Scholar
  18. 18.
    Yamaguchi J, Truman G, Cameron ID (2000) Lifestyle factors affecting bone ultrasonometry of the calcaneus in Japanese women. Calcif Tissue Int 66:43–46CrossRefPubMedGoogle Scholar
  19. 19.
    Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936CrossRefPubMedGoogle Scholar
  20. 20.
    Krieg MA, Cornuz J, Ruffieux C, Sandini L, Buche D, Dambacher MA, Hartl F, Hauselmann HJ, Kraenzlin M, Lippuner K, Neff M, Pancaldi P, Rizzoli R, Tanzi F, Theiler R, Tyndall A, Wimpfheimer K, Burckhardt P (2003) Comparison of three bone ultrasounds for the discrimination of subjects with and without osteoporotic fractures among 7562 elderly women. J Bone Miner Res 18:1261–1266PubMedGoogle Scholar
  21. 21.
    Drozdzowska B, Pluskiewicz W, de Terlizzi F (2003) The usefulness of quantitative ultrasound at the hand phalanges in the detection of the different types of nontraumatic fractures. Ultrasound Med Biol 29:1545–1550CrossRefPubMedGoogle Scholar
  22. 22.
    Hartl F, Tyndall A, Kraenzlin M, Bachmeier C, Guckel C, Senn U, Hans D, Theiler R (2002) Discriminatory ability of quantitative ultrasound parameters and bone mineral density in a population-based sample of postmenopausal women with vertebral fractures: results of the Basel Osteoporosis Study. J Bone Miner Res 17:321–330PubMedGoogle Scholar
  23. 23.
    Glüer CC, Hans D (1999) How to use ultrasound for risk assessment: a need for defining strategies. Osteoporos Int 9:193–195PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • Peter Alexandersen
    • 1
  • Francesca de Terlizzi
    • 2
  • Laszló B. Tankó
    • 1
  • Yu Z. Bagger
    • 1
  • Claus Christiansen
    • 1
  1. 1.Center for Clinical and Basic ResearchBallerupDenmark
  2. 2.IGEACarpiItaly

Personalised recommendations