Discrimination of fractures by low-frequency axial transmission ultrasound in postmenopausal females
- 335 Downloads
In this cross-sectional study, 95 postmenopausal women, with and without fracture history, were measured by low-frequency axial transmission ultrasound. The measured ultrasound velocity discriminated the fractured subjects from the nonfractured ones equally or better than peripheral quantitative computed tomography (pQCT) and dual energy x-ray absorptiometry (DXA). These results suggest that low-frequency ultrasound is suitable for bone fragility assessment.
Quantitative low-frequency axial transmission ultrasound is a promising modality for assessing mineral density and geometrical properties of long bones such as radius and tibia. The aim of the current study was to evaluate the ability of low-frequency axial transmission ultrasound to discriminate fractures retrospectively in postmenopausal women.
A cross-sectional study involved 95 female subjects aged 45–88 years, whose fracture information was gathered retrospectively. The fracture group was defined as subjects with one or more low-/moderate-energy fractures. The radius and tibial shaft were measured with a custom-made ultrasonometer to assess the velocity of the low-frequency first-arriving signal (VLF). Site-matched pQCT was used to measure volumetric cortical and subcortical bone mineral density (sBMD), and cortical thickness (CTh). Areal BMD (aBMD) was measured using DXA for the whole body (WB), lumbar spine, and hip.
The majority (19/32; 59 %) of the fractures were in the upper limb. VLF in the radius, but not in the tibia, discriminated fractures with an age- and BMI-adjusted odds ratio (OR) of 2.06 (95 % CI 1.21–3.50, p < 0.01). In the radius, CTh and cortical BMD (CBMD) significantly discriminated fractures, as did the total, cortical, and sBMD in the tibia (adjusted OR 1.35–2.15, p < 0.05). Sensitivity and specificity were similar among all the measurements (area under the receiver operating characteristic curve 0.74–0.81, p < 0.001).
Low-frequency axial transmission ultrasound in the radius was able to discriminate fractured subjects from the nonfractured ones. This suggests that low-frequency axial transmission ultrasound has the potential to assess bone fragility in postmenopausal women.
KeywordsAxial transmission Bone fracture Cortical bone Osteoporosis Quantitative ultrasound Speed of sound
- 4.Stone KL, Seeley DG, Lui LY, Cauley JA, Ensrud K, Browner WS, Nevitt MC, Cummings SR, Osteoporotic Fractures Research Group (2003) BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res 18:1947–1954CrossRefGoogle Scholar
- 7.Glüer CC, Eastell R, Reid DM, Felsenberg D, Roux C, Barkmann R, Timm W, Blenk T, Armbrecht G, Stewart A, Clowes J, Thomasius FE, Kolta S (2004) Association of five quantitative ultrasound devices and bone densitometry with osteoporotic vertebral fractures in a population-based sample: the OPUS Study. J Bone Miner Res 19:782–793PubMedCrossRefGoogle Scholar
- 8.Krieg MA, Cornuz J, Ruffieux C, Van Melle G, Büche D, Dambacher MA, Hans D, Hartl F, Häuselmann HJ, Kraenzlin M, Lippuner K, Neff M, Pancaldi P, Rizzoli R, Tanzi F, Theiler R, Tyndall A, Wimpfheimer C, Burckhardt P (2006) Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study. J Bone Miner Res 21:1457–1463PubMedCrossRefGoogle Scholar
- 27.Kärkkäinen M, Tuppurainen M, Salovaara K, Sandini L, Rikkonen T, Sirola J, Honkanen R, Jurvelin J, Alhava E, Kröger H (2010) Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65–71years: a 3-year randomized population-based trial (OSTPRE-FPS). Osteoporos Int 21:2047–2055PubMedCrossRefGoogle Scholar
- 34.Cheng S, Lyytikäinen A, Kröger H, Lamberg-Allardt C, Alén M, Koistinen A, Wang QJ, Suuriniemi M, Suominen H, Mahonen A, Nicholson PH, Ivaska KK, Korpela R, Ohlsson C, Väänänen KH, Tylavsky F (2005) Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10–12-y-old girls: a 2-y randomized trial. Am J Clin Nutr 82:1115, 26; quiz 1147-8PubMedGoogle Scholar
- 44.Report of a WHO Scientific Group (ed) (2003) Prevention and management of osteoporosis, WHO technical report series, no. 921. World Health Organisation, GenevaGoogle Scholar